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General NPI Number Information
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NPI Number | 1487315685
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Entity Type | Organization
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Legal Business Name | CHRISTIAN MEDICAL PLLC
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 1309 LUVERNE DR
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City | WYLIE
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State | TX
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Zip | 75098-8607
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Country | US
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Telephone | 814-323-5744
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Fax |
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Provider Business Mailing Address
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Address Line | 1309 LUVERNE DR
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City | WYLIE
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State | TX
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Zip | 75098-8607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ESPIRIDION MENDEZ
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Credential | DO
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Telephone | 814-323-5744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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