Provider Demographics
NPI:1063001303
Name:COREAS MELENDEZ, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:COREAS MELENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 FM 2920 RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3004
Mailing Address - Country:US
Mailing Address - Phone:281-353-2982
Mailing Address - Fax:
Practice Address - Street 1:5251 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3004
Practice Address - Country:US
Practice Address - Phone:281-353-2982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician