Provider Demographics
NPI:1255590428
Name:MENDEZ, LOUISA
Entity type:Individual
Prefix:
First Name:LOUISA
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 KOEPSEL RD
Mailing Address - Street 2:
Mailing Address - City:MC QUEENEY
Mailing Address - State:TX
Mailing Address - Zip Code:78123-3535
Mailing Address - Country:US
Mailing Address - Phone:830-556-4945
Mailing Address - Fax:
Practice Address - Street 1:167 KOEPSEL RD
Practice Address - Street 2:
Practice Address - City:MC QUEENEY
Practice Address - State:TX
Practice Address - Zip Code:78123-3535
Practice Address - Country:US
Practice Address - Phone:830-556-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No385H00000XRespite Care FacilityRespite Care