Provider Demographics
NPI:1245724111
Name:MELENDEZ-GARCIA, MONIQUE (SLP)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:MELENDEZ-GARCIA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 W SESAME DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7930
Mailing Address - Country:US
Mailing Address - Phone:956-399-4500
Mailing Address - Fax:
Practice Address - Street 1:2401 N ED CAREY DR STE A
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8207
Practice Address - Country:US
Practice Address - Phone:956-230-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114024235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114024OtherLICENSE