Provider Demographics
NPI:1316499247
Name:LAND, CHRISTINA MICHELLE MENDEZ (AUD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MICHELLE MENDEZ
Last Name:LAND
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7509 MENCHACA RD UNIT 203
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-6055
Mailing Address - Country:US
Mailing Address - Phone:512-829-8690
Mailing Address - Fax:512-661-2056
Practice Address - Street 1:7509 MENCHACA RD UNIT 203
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-6055
Practice Address - Country:US
Practice Address - Phone:512-829-8690
Practice Address - Fax:512-661-2056
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80796237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80796OtherTDLR - STATE LICENSE