Healthcare Provider Details

I. General information

NPI: 1780416891
Provider Name (Legal Business Name): NAYI MENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25201 KUYKENDAHL RD STE 700
TOMBALL TX
77375-3402
US

IV. Provider business mailing address

19803 KELLY LN
TOMBALL TX
77377-8876
US

V. Phone/Fax

Practice location:
  • Phone: 281-894-1423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7272
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: