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General NPI Number Information
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NPI Number | 1417630401
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Entity Type | Organization
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Legal Business Name | MEND PHYSICIAN SERVICES PLLC
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 2025 GUADALUPE ST STE 260
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City | AUSTIN
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State | TX
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Zip | 78705-5642
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Country | US
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Telephone | 917-382-0243
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 96239
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City | PHOENIX
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State | AZ
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Zip | 85072-6239
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Country | US
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Telephone | 917-382-0243
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Fax | 315-273-0243
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE MANAGEMEN
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Name | MICHELE LEE MCMULLEN
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Credential |
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Telephone | 917-336-7808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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