Provider Demographics
NPI:1760886089
Name:ABILEZ, MENDY A (DC)
Entity Type:Individual
Prefix:DR
First Name:MENDY
Middle Name:A
Last Name:ABILEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MENDY
Other - Middle Name:A
Other - Last Name:SANDOVAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 700688
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78270-0688
Mailing Address - Country:US
Mailing Address - Phone:800-404-6050
Mailing Address - Fax:866-313-3397
Practice Address - Street 1:295 E RENFRO ST STE 215
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3950
Practice Address - Country:US
Practice Address - Phone:210-318-3007
Practice Address - Fax:210-468-0682
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12763111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12763OtherCHIROPRACTIC LICENSE