Individual provider Active NPI

Judith Milena Mendez, FNP

  • Family Nurse Practitioner
  • Garland, TX
National Provider Identifier
1588430987
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1087948 Issued in TX
Practice address
710 E. Centerville Rd.
Garland, TX 75041
Phone
(972) 905-3520
Fax
(972) 278-3485
NPI assigned
Nov 28, 2023
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1087948 TX Primary
Family Nurse Practitioner 363LF0000X F11230471 TX

Addresses

Primary practice location

710 E. Centerville Rd.
Garland, TX 75041

Mailing address

710 E. Centerville Rd.
Garland, TX 75041
Phone (972) 905-3520

Other names 1

  • Judith Milena Guerrero Perdomo Other name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1087948TXMDFamily Nurse Practitioner
F11230471TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cumbre Medical Center LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

710 E Centerville Rd
Garland, TX 75041
Phone (972) 905-3520

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1588430987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E. CENTERVILLE RD.",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75041",
            "telephone_number": "972-905-3520",
            "fax_number": "972-278-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E. CENTERVILLE RD.",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75041",
            "telephone_number": "972-905-3520",
            "fax_number": "972-278-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JUDITH",
        "middle_name": "MILENA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-04-01",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1087948",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F11230471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "GUERRERO PERDOMO",
            "middle_name": "MILENA",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.