MENDIVIL CLINIC FOR FOOT AND ANKLE SURGERY AND REGENERATIVE MEDICINE NPI 1396524054

NPI Information

NPI: 1396524054
Provider Name: MENDIVIL CLINIC FOR FOOT AND ANKLE SURGERY AND REGENERATIVE MEDICINE
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
13472 EASTLAKE BLVD STE A
HORIZON CITY, TX
ZIP 79928
Phone: (915) 309-0513
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MENDIVIL CLINIC FOR FOOT AND ANKLE SURGERY AND REGENERATIVE MEDICINE is a foot and ankle surgery podiatrist in Horizon City, TX. MENDIVIL CLINIC FOR FOOT AND ANKLE SURGERY AND REGENERATIVE MEDICINE NPI is 1396524054. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

13472 EASTLAKE BLVD STE A
HORIZON CITY, TX
ZIP 79928-320
Phone: (915) 309-0513

The provider's authorized official is Jason Mendivil .
The authorized official title is Owner and has the following contact phone number (915) 309-0513.

The enumeration date for this NPI number is 9/22/2023 and was last updated on 9/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery			Yes

What is NPI?

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This page was last updated on: 5/5/2024

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