Individual
DR. ERNEST J MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22710 PROFESSIONAL DR, SUITE 202, KINGWOOD, TX 77339-6008
(281) 312-8521
(281) 359-7971
Mailing address
21083 WILLIAMS CREEK DR, PORTER, TX 77365-2380
(713) 299-5727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M0491
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10034812
AMERIGROUP COMMUNITY CARE
TX
05
—
172500401
—
TX
01
—
8R9840
BLUE CROSS BLUE SHIELD
TX
01
—
P00235710
RAILROAD MEDICARE
TX
Enumeration date
11/09/2005
Last updated
03/16/2012
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