Provider Demographics
NPI:1316066996
Name:MENDOZA, NORMA SANTOS (MD)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:SANTOS
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 NOBLE LAKES LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6810
Mailing Address - Country:US
Mailing Address - Phone:281-496-3006
Mailing Address - Fax:281-496-3005
Practice Address - Street 1:3107 NOBLE LAKES LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6810
Practice Address - Country:US
Practice Address - Phone:281-496-3006
Practice Address - Fax:281-496-3005
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4479225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC19304Medicare UPIN
TX00RF08Medicare ID - Type Unspecified