Individual provider Active NPI

Victor Manuel Mendoza, LVN

  • Licensed Vocational Nurse
  • El Paso, TX
National Provider Identifier
1093532129
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
201409 Issued in TX
Practice address
350 Revere St
El Paso, TX 79905-1633
Phone
(915) 564-6159
NPI assigned
Sep 20, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 201409 TX Primary

Addresses

Primary practice location

350 Revere St
El Paso, TX 79905-1633

Mailing address

350 Revere St
El Paso, TX 79905-1633
Phone (915) 564-6159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
201409TXMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1093532129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 REVERE ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051633",
            "telephone_number": "915-564-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 REVERE ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051633",
            "telephone_number": "915-564-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "VICTOR",
        "middle_name": "MANUEL",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "201409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.