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Individual
JACQUELINE MENDEZ
Active
Individual
JACQUELINE MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1100628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
454104701
—
TX
01
—
8TL747
BCBS TX
TX
Enumeration date
12/09/2022
Last updated
12/08/2023
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