Individual
MARILYN MENCHACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 8TH AVE STE 120, FORT WORTH, TX 76104-4156
(817) 923-6900
Mailing address
1250 8TH AVE STE 120, FORT WORTH, TX 76104-4156
(817) 923-6900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1156996
TX
Other
Enumeration date
03/27/2023
Last updated
06/13/2024
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