Provider Demographics
NPI:1326932641
Name:MENDIOLA, DANIELA M
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:M
Last Name:MENDIOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 735
Mailing Address - Street 2:
Mailing Address - City:LYFORD
Mailing Address - State:TX
Mailing Address - Zip Code:78569-0735
Mailing Address - Country:US
Mailing Address - Phone:956-272-9718
Mailing Address - Fax:
Practice Address - Street 1:402 S SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:CO
Practice Address - Zip Code:80734-1220
Practice Address - Country:US
Practice Address - Phone:956-272-9718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide