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General NPI Number Information
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NPI Number | 1912636515
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Entity Type | Individual
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Provider Name | MAYLEN MENDEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 12311 NACOGDOCHES RD STE 107
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2139
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Country | US
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Telephone | 210-742-7248
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Fax |
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Provider Business Mailing Address
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Address Line | 6235 PECAN TREE
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1867
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Country | US
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Telephone | 786-553-2724
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 38445
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License Number State | TX
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