Provider Demographics
NPI:1588430987
Name:MENDEZ, JUDITH MILENA (FNP)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:MILENA
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:MILENA
Other - Last Name:GUERRERO PERDOMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:710 E. CENTERVILLE RD.
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041
Mailing Address - Country:US
Mailing Address - Phone:972-905-3520
Mailing Address - Fax:972-278-3485
Practice Address - Street 1:710 E. CENTERVILLE RD.
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041
Practice Address - Country:US
Practice Address - Phone:972-905-3520
Practice Address - Fax:972-278-3485
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1087948363LF0000X
TXF11230471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily