person
Edith Marie Mendoza, NP
Psychiatric/Mental Health Nurse Practitioner in Southlake, Texas
NPI 1720713969

Edith Marie Mendoza is a Psychiatric/Mental Health Nurse Practitioner based in Southlake, TX and is specialized in Psychiatric/Mental Health. Edith Marie Mendoza practices in Southlake, TX and has the professional credentials of NP. The NPI Number for Edith Marie Mendoza is 1720713969 and holds a License No. AP1088173 (Texas).

The current practice location address for Edith Marie Mendoza is 2485 E Southlake Blvd Ste 100, Southlake, TX and can be reached out via phone at 817-873-0590 and via fax at 817-873-0591.

Location: 2485 E Southlake Blvd Ste 100, Southlake, TX, 76092-6687
person
Provider Profile Details
NPI Number
1720713969
Provider Name
Edith Marie Mendoza
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
2485 E Southlake Blvd Ste 100, Southlake, TX, 76092-6687
Phone Number
817-873-0590
Fax Number
817-873-0591
Provider Enumeration Date
07/21/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP1088173 01 TX APRN
630874 01 TX RN
institution
Provider Business Practice Location Address Details
Address
2485 E Southlake Blvd Ste 100
City
State
Zip
76092-6687
Phone Number
817-873-0590
Fax Number
817-873-0591
person
Provider Business Mailing Address Details
Address
2485 E Southlake Blvd Ste 100
City
State
Zip
76092-6687
Phone Number
817-873-0590
Fax Number
817-873-0591
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
AP1088173 (Texas)
Definition
Definition to come...
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