Provider Demographics
NPI:1043968753
Name:MEANDE, FELICITE M (RVT)
Entity Type:Individual
Prefix:
First Name:FELICITE
Middle Name:M
Last Name:MEANDE
Suffix:
Gender:F
Credentials:RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 THORPE LN STE B
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7117
Mailing Address - Country:US
Mailing Address - Phone:512-210-8119
Mailing Address - Fax:
Practice Address - Street 1:1346 THORPE LN STE B
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7117
Practice Address - Country:US
Practice Address - Phone:512-210-8119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00096972246XC2903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Single Specialty