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NPI Code Detail

MEDICARE: MRS. MARY E MENSCH CCP LP

MEDICARE: MRS. MARY E MENSCH CCP LP
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
1242T00000XPerfusionistFPF00000144TX

General Provider Information

NPI Number : 1376771451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY E MENSCH CCP LP
Provider Business Mailing Address
First Line : 14603 HUEBNER RD
Second Line : BLD 28 STE 2801
City : SAN ANTONIO
State : TX
Zip : 78230-5469
Country : US
Telephone Number : 210-614-7074
Fax Number : 210-614-7091
Provider Business Practice Location Address
First Line : 14603 HUEBNER RD
Second Line : BLD 28 STE 2801
City : SAN ANTONIO
State : TX
Zip : 78230-5469
Country : US
Telephone Number : 210-614-7074
Fax Number : 210-614-7091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2009
Last Update Date : 01/13/2020

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Directions to “ MRS. MARY E MENSCH CCP LP” Practice Location

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