Mendivil, Jason Max

Mendivil, Jason Max is an sole proprietor health care provider with primary practice located at 4646 N Mesa St , El Paso TX 79912-6104. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Prosthetic/Orthotic Supplier, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Mendivil, Jason Max can be contacted via phone (915) 313-6300.

Contact Information

Primary practice address
4646 N Mesa St El Paso TX 79912-6104
Phone: (915) 313-6300
Fax: (915) 521-2028
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 2205 Texas
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Prosthetic/Orthotic Supplier 335E00000X
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 2205 Texas

Profile Details

NPI number 1790117893
LBN Legal business name Mendivil, Jason Max
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2013
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790117893 NPPES
Texas MEDICAID 358170402

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