Organization
FANNETT MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGELIO MENDOZA M.D. (DIRECTOR/OWNER)
(409) 794-2314
Entity
Organization
Contact information
Practice address
15321 HIGHWAY 124, BEAUMONT, TX 77705-9127
(409) 794-2314
Mailing address
3535 GRAYSON LN, BEAUMONT, TX 77713-4158
(409) 201-2994
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
AP127771
TX
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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