Provider Demographics
NPI:1427588789
Name:MENARD MEDICAL, PLLC
Entity Type:Organization
Organization Name:MENARD MEDICAL, PLLC
Other - Org Name:MEDSPOT URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MENARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RN, FNP-BC
Authorized Official - Phone:832-721-1854
Mailing Address - Street 1:423 MARINA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4388
Mailing Address - Country:US
Mailing Address - Phone:832-721-1854
Mailing Address - Fax:
Practice Address - Street 1:18201 GULF FWY STE C
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-3805
Practice Address - Country:US
Practice Address - Phone:832-721-1854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121072363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty