Theodore Bulacan Mendoza III, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP136094 Issued in TX

Practice address

6407 S Cooper St Ste 117
Arlington, TX 76001-5813

Phone

(817) 472-7601

NPI assigned

Apr 3, 2018

Last updated

Apr 3, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• United Primary Clinic Care LLC

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1881419620
  Medicare reassignment NPD
• Walk-in & Urgent Care PA

  • Internal Medicine Physician
  • Arlington, TX
  • NPI 1912277260
  Medicare reassignment NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1336645928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7328 LAGUNA",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540139",
            "telephone_number": "972-898-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6407 S COOPER ST STE 117",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760015813",
            "telephone_number": "817-472-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "THEODORE",
        "middle_name": "BULACAN",
        "name_suffix": "III",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Mendez
• Mending Hearts Home Care Agency
• Theresa Menditto, DPT
• Charmaine V Mendoza, PT
• Samantha Mendoza
• Sarah Mensah-Taylor
• Mental Health Consultants of Texas
• Paul Edward Menton, D.D.S.
• Angel Ray Mercado
• Lee Charles Mercer Jr., DDS

• Family Nurse Practitioner in Arlington, TX
• Providers in Arlington, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.