# UNIVERSITY VASCULAR SPECIALIST, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104051754
- **Authorized official:** DR. ROBERT RALPH MENDES M.D. (PARTNER)
- **Authorized official phone:** (706) 722-2334

## Contact information

- **Practice address:** 818 SAINT SEBASTIAN WAY, SUITE 408, AUGUSTA, GA 30901-2651
- **Practice address phone:** (706) 722-2334
- **Practice address fax:** (706) 724-8495
- **Mailing address:** 818 SAINT SEBASTIAN WAY, SUITE 408, AUGUSTA, GA 30901-2651
- **Mailing address phone:** (706) 722-2334
- **Mailing address fax:** (706) 724-8495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2009
- **Last updated:** 05/27/2009