Provider Demographics
NPI:1164964805
Name:MENDOZA-ZAVALA, HERMES (MSN, APRN, PMHNP)
Entity Type:Individual
Prefix:
First Name:HERMES
Middle Name:
Last Name:MENDOZA-ZAVALA
Suffix:
Gender:M
Credentials:MSN, APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 NIGHTINGALE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-1714
Mailing Address - Country:US
Mailing Address - Phone:956-800-4014
Mailing Address - Fax:956-800-4012
Practice Address - Street 1:323 NIGHTINGALE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-1714
Practice Address - Country:US
Practice Address - Phone:956-800-4014
Practice Address - Fax:956-800-4012
Is Sole Proprietor?:No
Enumeration Date:2016-11-11
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132486363LP0808X
TX803484163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse