Look up the most recent NPI and PECOS records

Jorge Luis Rodriguez Mendoza

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

232 E Crosstimbers St Ste E, Houston, TX 77022-4499

PECOS Enrollment

This provider is enrolled in PECOS as JORGE RODRIGUEZ MENDOZA.

Based on the most recent information from CMS, provider Jorge Luis Rodriguez Mendoza is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1720813579
Provider Type
Individual
Full Name
Rodriguez Mendoza, Jorge Luis
Credential
FNP-C, RN, BSN

Gender
Male
Sole Proprietor
No
Enumeration Date
9/3/2024
Last Updated
9/3/2024

Contact Information

Practice Location

232 E Crosstimbers St Ste E, Houston, TX 77022-4499

(832) 345-0232

Unlisted Fax

Mailing Location

11722 Champions Grove Ln, Houston, TX 77066-3355

(832) 345-0232

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 1066537 Texas
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License 1066537 Texas

Jorge Luis Rodriguez Mendoza

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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