Individual provider Active NPI

Jorge A. Mendoza-Valencia, LSA, SA-C.

  • Surgical Physician Assistant
  • Sugar Land, TX
National Provider Identifier
1235796392
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
SA00733 Issued in TX
Practice address
16655 Southwest Fwy
Sugar Land, TX 77479-2329
Phone
(281) 274-7000
NPI assigned
May 23, 2019
Last updated
Jan 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X SA00733 TX Primary
Surgical Assistant 246ZC0007X SA00733 TX

Addresses

Primary practice location

16655 Southwest Fwy
Sugar Land, TX 77479-2329

Mailing address

12250 S Kirkwood Rd Apt 734
Stafford, TX 77477-2121

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
SA00733TXMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1235796392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12250 S KIRKWOOD RD APT 734",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16655 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792329",
            "telephone_number": "281-274-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA-VALENCIA",
        "first_name": "JORGE",
        "middle_name": "A.",
        "credential": "LSA, SA-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00733",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00733",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.