Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 2084N0402X | TX |
NPI | 1083799001 |
---|---|
Provider Name | Dr. Leonardo Garcia-Mendez |
First Address | Mcallen, TX 78503-1387 |
Second Address | Mcallen, TX 78503-1387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 30/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
089894202 | (05) | TX |
F05532 | (02) | TX |
OOU84G | BLUE CROSS PROVIDER # (01) | TX |