Healthcare Provider Details

I. General information

NPI: 1366375511
Provider Name (Legal Business Name): JENIFFER ESMERALDA MENDEZ PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 N GARFIELD ST
MIDLAND TX
79705-6329
US

IV. Provider business mailing address

5503 MESA CIR
DALLAS TX
75235-6129
US

V. Phone/Fax

Practice location:
  • Phone: 432-620-1120
  • Fax:
Mailing address:
  • Phone: 214-797-6945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: