Provider Demographics
NPI:1346523859
Name:MONDLAK, BRITTANY JANELLE (NP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JANELLE
Last Name:MONDLAK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:JANELLE
Other - Last Name:BACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9440A HIGHWAY 6 S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9440A HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6307
Practice Address - Country:US
Practice Address - Phone:281-408-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169592363L00000X
TXAP127015363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner