Active NPI
Ezequiel Mendieta Jr., B.S., R.PH., M.P.H.
- Pharmacist
- Corpus Christi, TX
National Provider Identifier
1326046749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21221
- Practice address
- 3317 Casa Bonita Dr
Corpus Christi, TX 78411-3307 - Phone
- (361) 814-5633
- Fax
- (361) 814-5633
- NPI assigned
- Jul 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21221 | TX | Primary |
| Pharmacist | 183500000X | 1169 | AK |
Addresses
Primary practice location
3317 Casa Bonita Dr
Corpus Christi, TX 78411-3307
Mailing address
3317 Casa Bonita Dr
Corpus Christi, TX 78411-3307
Phone (361) 814-5633
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
- Credentials
- Bachelor of Science, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21221 | TX | MD | General Practice Dentistry |
| 1169 | AK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326046749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3317 CASA BONITA DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784113307",
"telephone_number": "361-814-5633",
"fax_number": "361-814-5633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3317 CASA BONITA DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784113307",
"telephone_number": "361-814-5633",
"fax_number": "361-814-5633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDIETA",
"first_name": "EZEQUIEL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "B.S., R.PH., M.P.H.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "21221",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AK",
"license": "1169",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.