Provider Demographics
NPI:1629066444
Name:MENDEZ, LAURA L (RN,WHCNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:RN,WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 KINGSRIDE LN
Mailing Address - Street 2:#199
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4116
Mailing Address - Country:US
Mailing Address - Phone:281-807-9737
Mailing Address - Fax:
Practice Address - Street 1:12335 KINGSRIDE LN
Practice Address - Street 2:#199
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4116
Practice Address - Country:US
Practice Address - Phone:281-807-9737
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572866363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology