Provider Demographics
NPI:1548267255
Name:MENDEZ, MARIA MINERVA (ANP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MINERVA
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MINERVA
Other - Last Name:ARRIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:7500 BARLITE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1361
Mailing Address - Country:US
Mailing Address - Phone:210-921-3939
Mailing Address - Fax:210-921-3941
Practice Address - Street 1:7500 BARLITE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1361
Practice Address - Country:US
Practice Address - Phone:210-921-3939
Practice Address - Fax:210-921-3941
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB156242OtherWELLMED MEDICARE
TX154835604OtherWELLMED MEDICAID