Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | F5304 | TX |
NPI | 1225036163 |
---|---|
Provider Name | Dr. Rogelio Menendez |
First Address | El Paso, TX 79925-7948 |
Second Address | El Paso, TX 79925-7948 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E10195 | (02) | TX |
P000DV685 | (05) | TX |