Organization
PAUL E MONDOLFI, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHA M LAQUA (OFFICE MANAGER)
(361) 580-1574
Entity
Organization
Contact information
Practice address
605 E SAN ANTONIO ST, SUITE 450 E, VICTORIA, TX 77901-6040
(361) 580-1574
(361) 570-3709
Mailing address
605 E SAN ANTONIO ST, SUITE 450 E, VICTORIA, TX 77901-6040
(361) 580-1574
(361) 570-3709
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
J9761
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089873603
—
TX
Enumeration date
02/02/2010
Last updated
12/11/2012
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