Rosa Isela Mendoza, RN

Individual provider Active NPI General Practice Registered Nurse · Whitney, TX

NPI 1316106982 · NPPES record last updated Jun 8, 2008

Key facts

NPI
1316106982
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
695861 (TX)
Practice address
1409 Highway 22
Whitney, TX 76692-7624
Phone
(254) 694-7144
NPI assigned
Jun 8, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
695861TXMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 695861 TX Yes

Addresses

Primary practice location

1409 Highway 22
Whitney, TX 76692-7624

Mailing address

492 FM 2604
Whitney, TX 76692-4664
Phone (254) 694-7144

Other providers in Whitney, TX

All providers in Whitney, TX · General Practice Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.