Active NPI
Dana Mendoza
- Family Nurse Practitioner
- Montgomery, TX
National Provider Identifier
1023909736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1015398
- Practice address
- 123 Blue Heron Dr Ste 101
Montgomery, TX 77316-3192 - Phone
- (936) 290-0761
- NPI assigned
- Jul 10, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1015398 | TX | Primary |
Addresses
Primary practice location
123 Blue Heron Dr Ste 101
Montgomery, TX 77316-3192
Mailing address
15436 Crown Oaks Dr
Montgomery, TX 77316-9623
Phone (619) 212-0629
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Texas Medical School at Houston, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
123 Blue Heron Dr
Suite 101
Montgomery, TX 77316-3192
Phone (936) 290-0761
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1015398 | TX | MD | Family Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Nurse Practitioner
- Montgomery, TX
- NPI 1881369585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752105600000",
"number": "1023909736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15436 CROWN OAKS DR",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773169623",
"telephone_number": "619-212-0629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 BLUE HERON DR STE 101",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773163192",
"telephone_number": "936-290-0761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "DANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-10",
"last_updated": "2025-07-10",
"certification_date": "2025-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1015398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montgomery, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.