Provider Demographics
NPI:1740929959
Name:WOMAN'S PLACE FOR OPTIMAL WELLNESS & LONGEVITY LLC
Entity type:Organization
Organization Name:WOMAN'S PLACE FOR OPTIMAL WELLNESS & LONGEVITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMOHANO-MENDIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, WHNP-BC
Authorized Official - Phone:956-686-3900
Mailing Address - Street 1:4304 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2477
Mailing Address - Country:US
Mailing Address - Phone:956-686-3900
Mailing Address - Fax:956-686-3323
Practice Address - Street 1:4304 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2477
Practice Address - Country:US
Practice Address - Phone:956-686-3900
Practice Address - Fax:956-686-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-04
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty