Provider Demographics
NPI:1528517174
Name:MESSER, BRENDA BONNIE
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:BONNIE
Last Name:MESSER
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 1:11989 MESQUITE LAKE LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3318
Mailing Address - Country:US
Mailing Address - Phone:910-853-2411
Mailing Address - Fax:
Practice Address - Street 1:905 NOBLE ST STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4739
Practice Address - Country:US
Practice Address - Phone:915-472-4632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0165231041C0700X
TX1044601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical