Individual provider Active NPI

Federico Mendez, MS, LMFT

  • Marriage & Family Therapist
  • Fort Worth, TX
National Provider Identifier
1336877265
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
203769 Issued in TX
Practice address
3900 Merrett Dr
Fort Worth, TX 76135-2920
Phone
(817) 631-9991
NPI assigned
Aug 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 203769 TX Primary

Addresses

Primary practice location

3900 Merrett Dr
Fort Worth, TX 76135-2920

Mailing address

4553 Glenview CT
North Richland Hills, TX 76180-7349
Phone (903) 466-2643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124002216 TX Practitioner - Marriage and Family Therapist 9537512769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
203769TXMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1336877265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 GLENVIEW CT",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807349",
            "telephone_number": "903-466-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 MERRETT DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761352920",
            "telephone_number": "817-631-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "FEDERICO",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "203769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.