Individual
MARISELA MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1820 LONE STAR DR, ODESSA, TX 79766-9040
(432) 438-7551
Mailing address
1820 LONE STAR DR, ODESSA, TX 79766-9040
(432) 438-7551
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
344955
TX
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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