Provider Demographics
NPI:1336877265
Name:MENDEZ, FEDERICO (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:FEDERICO
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4553 GLENVIEW CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7349
Mailing Address - Country:US
Mailing Address - Phone:903-466-2643
Mailing Address - Fax:
Practice Address - Street 1:3900 MERRETT DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-2920
Practice Address - Country:US
Practice Address - Phone:817-631-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203769106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty