Provider Demographics
NPI:1659131290
Name:MENDY, HENRY
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:MENDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 PELHAM DR
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-4455
Mailing Address - Country:US
Mailing Address - Phone:901-212-9833
Mailing Address - Fax:
Practice Address - Street 1:2017 PELHAM DR
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-4455
Practice Address - Country:US
Practice Address - Phone:901-212-9833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health