Provider Demographics
NPI:1043193741
Name:MENDEZ - ESTRADA, MILLIE (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MILLIE
Middle Name:
Last Name:MENDEZ - ESTRADA
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5446 LIPES BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2509
Mailing Address - Country:US
Mailing Address - Phone:361-992-6100
Mailing Address - Fax:361-992-0665
Practice Address - Street 1:5446 LIPES BLVD STE 101
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2509
Practice Address - Country:US
Practice Address - Phone:361-992-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1213792363LF0000X
TX743575163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase Management