Provider Demographics
NPI:1619850971
Name:GOMEZ MENDOZA, ALEXIS RAMSES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:RAMSES
Last Name:GOMEZ MENDOZA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12787 IVANHOE ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-4685
Mailing Address - Country:US
Mailing Address - Phone:229-921-1528
Mailing Address - Fax:
Practice Address - Street 1:3247 23RD AVE
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:CO
Practice Address - Zip Code:80620-1733
Practice Address - Country:US
Practice Address - Phone:970-330-5739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0025265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist