Provider Demographics
NPI:1487622189
Name:ALVAREZ-MENDOZA, ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:ALVAREZ-MENDOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 MCPHERSON RD
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6268
Mailing Address - Country:US
Mailing Address - Phone:956-523-2067
Mailing Address - Fax:956-523-2822
Practice Address - Street 1:301 W EXPRESSWAY 83
Practice Address - Street 2:LABORATORY DEPT
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-3045
Practice Address - Country:US
Practice Address - Phone:956-632-5588
Practice Address - Fax:956-550-4314
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0602207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143690901Medicaid
H30252Medicare UPIN