Individual
ERIC N MENDELOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 FOREST LN, SUITE B-115, DALLAS, TX 75230-2505
(972) 566-2525
(972) 566-2032
Mailing address
PO BOX 402018, ATLANTA, GA 30384-2018
(915) 373-7600
(615) 373-7651
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
L7810
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100064120B
—
OK
05
—
1196107
—
TX
01
—
8X5490
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/10/2005
Last updated
08/15/2008
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