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General NPI Number Information
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NPI Number | 1407123920
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Entity Type | Individual
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Provider Name | HEATHER J MENENDEZ PT
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Gender | Female
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 2224 N CARROLL BLVD
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City | DENTON
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State | TX
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Zip | 76201-1834
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Country | US
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Telephone | 940-387-6656
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Fax |
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Provider Business Mailing Address
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Address Line | 10181 CEDAR LAKE DR
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City | PROVIDENCE VILLAGE
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State | TX
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Zip | 76227-7548
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Country | US
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Telephone | 727-237-3141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1209178
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License Number State | TX
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