Provider Demographics
NPI:1699174243
Name:MENDEZ, TOM (LAT, ATC)
Entity type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 E 7TH ST
Mailing Address - Street 2:APT 334
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3909
Mailing Address - Country:US
Mailing Address - Phone:786-537-7148
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF TEXAS BASEBALL
Practice Address - Street 2:1300 E MARTIN LUTHER KING JR BLVD
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702
Practice Address - Country:US
Practice Address - Phone:512-232-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer