Individual
SUSSETTI MARILU DE PENA MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
945 ROAD 5706, CLEVELAND, TX 77327
(346) 789-4364
Mailing address
945 ROAD 5706, CLEVELAND, TX 77327
(346) 789-4364
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
23-425
TX
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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