Individual
BLAKE MENCHACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AG-ACNP
Contact information
Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(823) 355-2666
Mailing address
21 SPURS LN, STE 230B, SAN ANTONIO, TX 78240-1669
(210) 690-7400
(210) 690-7405
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP132573
TX
363LC0200X
Critical Care Medicine Nurse Practitioner
AP132573
TX
Other
Enumeration date
11/09/2016
Last updated
10/03/2024
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