Healthcare Provider Details

I. General information

NPI: 1043193741
Provider Name (Legal Business Name): MILLIE MENDEZ - ESTRADA MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5446 LIPES BLVD STE 101
CORPUS CHRISTI TX
78413-2509
US

IV. Provider business mailing address

5446 LIPES BLVD STE 101
CORPUS CHRISTI TX
78413-2509
US

V. Phone/Fax

Practice location:
  • Phone: 361-992-6100
  • Fax:
Mailing address:
  • Phone: 361-992-6100
  • Fax: 361-992-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1213792
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number743575
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: