Provider Demographics
NPI:1376771451
Name:MENSCH, MARY E (CCP LP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:MENSCH
Suffix:
Gender:F
Credentials:CCP LP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:14603 HUEBNER RD
Mailing Address - Street 2:BLD 28 STE 2801
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5469
Mailing Address - Country:US
Mailing Address - Phone:210-614-7074
Mailing Address - Fax:210-614-7091
Practice Address - Street 1:14603 HUEBNER RD
Practice Address - Street 2:BLD 28 STE 2801
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5469
Practice Address - Country:US
Practice Address - Phone:210-614-7074
Practice Address - Fax:210-614-7091
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXFPF00000144242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist