1538566062 NPI number — THERESE FRANCESCA POSAS-MENDOZA MD

Table of content: THERESE FRANCESCA POSAS-MENDOZA MD (NPI 1538566062)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538566062 NPI number — THERESE FRANCESCA POSAS-MENDOZA MD

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
POSAS-MENDOZA

Provider First Name:
THERESE

Provider Middle Name:
FRANCESCA

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:
MD

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:
POSAS

Provider Other First Name:
THERESE

Provider Other Middle Name:
FRANCESCA

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:
MD

Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538566062

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
11/16/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20609 LA MESA CT

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:
MANDEVILLE

Provider Business Mailing Address State Name:
LA

Provider Business Mailing Address Postal Code:
70471-7212

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1341 OCHSNER BLVD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:
COVINGTON

Provider Business Practice Location Address State Name:
LA

Provider Business Practice Location Address Postal Code:
70433-8172

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
985-875-2828

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:
11/26/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

Provider Taxonomy Codes

Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Taxonomy code: 207RR0500X , with the licence number: 328399 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .