Mendoza Urias, Geronimo

Mendoza Urias, Geronimo is an individual health care provider with primary practice located at 721 E Holly St Suite B, Deming NM 88030-5245. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Mendoza Urias, Geronimo can be contacted via phone (575) 546-6010.

Contact Information

Primary practice address
721 E Holly St Suite B Deming NM 88030-5245
Phone: (575) 546-6010
Fax: (575) 546-4099
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X BP10043455 Texas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD2015-0230 New Mexico

Profile Details

NPI number 1356605877
LBN Legal business name Mendoza Urias, Geronimo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2012
Last updated Nov 2nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356605877 NPPES
New Mexico MEDICAID 26393

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