Individual
ANNA MARIE TEENA CAPULONG MENDIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
8061 ALAMEDA AVE, EL PASO, TX 79915-4705
(915) 859-7545
(915) 859-9862
Mailing address
8061 ALAMEDA AVE, EL PASO, TX 79915-4705
(915) 859-7545
(915) 859-9862
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
BP10031884
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130880104
GROUP MEDICAID
TX
01
—
1831267079
GROUP NPI
TX
01
—
451901
GROUP MEDICARE
TX
Enumeration date
07/01/2008
Last updated
07/21/2014
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