Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 46861 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | LT000692 | PA |
NPI | 1003132192 |
---|---|
Provider Name | Sara E Mendoza Crespo |
First Address | Austin, TX 78723-3079 |
Second Address | Austin, TX 78723-3079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 28/04/2020 |