Provider Demographics
NPI:1386383743
Name:MENDOZA, MARIA D
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 PASSMORE RD
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:TX
Mailing Address - Zip Code:79927-3264
Mailing Address - Country:US
Mailing Address - Phone:915-401-0381
Mailing Address - Fax:
Practice Address - Street 1:472 PASSMORE RD
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:TX
Practice Address - Zip Code:79927-3264
Practice Address - Country:US
Practice Address - Phone:915-401-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251E00000XAgenciesHome Health