MEDICARE: ANNA NIOMI MENDEZ-GUZMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP137268	TX

General Provider Information

NPI Number	:	1043717697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA NIOMI MENDEZ-GUZMAN

Provider Business Mailing Address
First Line	:	500 FORT WORTH DR STE 140
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-7527
Country	:	US
Telephone Number	:	940-320-0505
Fax Number	:	940-320-0506

Provider Business Practice Location Address
First Line	:	500 FORT WORTH DR STE 140
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-7527
Country	:	US
Telephone Number	:	940-320-0505
Fax Number	:	940-320-0506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	12/16/2025

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