Individual
ELIZABETH MENDOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
3201 OLD DENTON RD, CARROLLTON, TX 75007-3957
(972) 968-4900
Mailing address
701 LEORA LN APT 837, LEWISVILLE, TX 75056-3950
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT5639
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000013779
BOC CERTIFIED ATHLETIC TRAINER
—
01
—
59927
NATIONAL ATHLETIC TRAINERS ASSOCIATION MEMBER
—
Enumeration date
03/24/2018
Last updated
03/24/2018
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