Provider Demographics
NPI:1962914572
Name:MENDIOLA, ROBERTO JR (RDN)
Entity type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:
Last Name:MENDIOLA
Suffix:JR
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 S FLORES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204-1219
Mailing Address - Country:US
Mailing Address - Phone:855-481-1149
Mailing Address - Fax:855-710-7869
Practice Address - Street 1:700 LOUIS HENNA BLVD APT 911
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5741
Practice Address - Country:US
Practice Address - Phone:956-434-6154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-05
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered