Individual provider Active NPI

Victor O Mendiola, MD

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1336202134
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6016 Issued in TX
Practice address
1415 N Loop W
Suite 940
Houston, TX 77008
Phone
(713) 697-4705
Fax
(713) 697-4763
NPI assigned
Dec 19, 2006
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J6016 TX Primary

Addresses

Primary practice location

1415 N Loop W
Suite 940
Houston, TX 77008

Mailing address

PO Box 1205
Sugar Land, TX 77487-1205
Phone (713) 697-4705

Other identifiers 2

IdentifierTypeStateIssuer
127001904MedicaidTX
127001905MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100215000566 TX Practitioner - Family Practice 0345384384 Reassigns benefits to 1 organization
Practice locations: Houston, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1415 N Loop W
Suite 940
Houston, TX 77008-5602
Phone (713) 697-4705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J6016TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mendiola Family Healthcare PLLC Family Medicine CurrentSince Aug 24, 2021 Accepting new patients
William Z Cohen MD PA Family Medicine PastSince Oct 15, 1997 Accepting new patients

Locations

1415 North Loop W
Ste 940
Houston, TX 77008
Phone (713) 691-0107

427 W 20th St
Ste 503
Houston, TX 77008
Phone (713) 802-9999

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1336202134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1205",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774871205",
            "telephone_number": "713-697-4705",
            "fax_number": "713-697-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N LOOP W",
            "address_2": "SUITE 940",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77008",
            "telephone_number": "713-697-4705",
            "fax_number": "713-697-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIOLA",
        "first_name": "VICTOR",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127001904",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127001905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.