Provider Demographics
NPI:1730750522
Name:VAZQUEZ MENDEZ, ENRIQUE ALEJANDRO (MD)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:ALEJANDRO
Last Name:VAZQUEZ MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BOULEVARD
Mailing Address - Street 2:5.140 JOHN SEALY ANNEX
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555
Mailing Address - Country:US
Mailing Address - Phone:409-772-0750
Mailing Address - Fax:409-772-4456
Practice Address - Street 1:301 UNIVERSITY BOULEVARD
Practice Address - Street 2:5.140 JOHN SEALY ANNEX
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555
Practice Address - Country:US
Practice Address - Phone:409-772-2436
Practice Address - Fax:409-772-9532
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL5553R207R00000X
TXBP10089935207RP1001X, 207RC0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program