Provider Demographics
NPI:1063726198
Name:MENDEZ MONTALVO, PAULA ANDREA (DDS)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:ANDREA
Last Name:MENDEZ MONTALVO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16545 S.W FWY STE 270
Mailing Address - Street 2:
Mailing Address - City:SUGARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:713-234-7800
Mailing Address - Fax:713-234-7202
Practice Address - Street 1:16545 S.W FWY STE 270
Practice Address - Street 2:
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:713-234-7800
Practice Address - Fax:713-234-7202
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25824122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist