| Mendivil Clinic For Foot And Ankle Surgery And Regenerative Medicine | |
|
13472 Eastlake Blvd Ste A Horizon City TX 79928-6320 | |
| (915) 309-0513 | |
| Not Available |
| Full Name | Mendivil Clinic For Foot And Ankle Surgery And Regenerative Medicine |
|---|---|
| Speciality | Podiatrist |
| Location | 13472 Eastlake Blvd Ste A, Horizon City, Texas |
| Authorized Official Name and Position | Jason Mendivil (OWNER) |
| Authorized Official Contact | 9153090513 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mendivil Clinic For Foot And Ankle Surgery And Regenerative Medicine 12339 Chianti Dr El Paso TX 79928-8644 Ph: () - | Mendivil Clinic For Foot And Ankle Surgery And Regenerative Medicine 13472 Eastlake Blvd Ste A Horizon City TX 79928-6320 Ph: (915) 309-0513 |
| NPI Number | 1396524054 |
|---|---|
| Provider Enumeration Date | 09/22/2023 |
| Last Update Date | 01/27/2025 |
| Medicare PECOS PAC ID | 3274988860 |
|---|---|
| Medicare Enrollment ID | O20231017003840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396524054 | NPI | - | NPPES |
| Provider Name | Jason M Mendivil |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790117893 PECOS PAC ID: 3577853845 Enrollment ID: I20160531000324 |
| Provider Name | Philip E Fidler |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1689643637 PECOS PAC ID: 9739241118 Enrollment ID: I20180808001014 |
| Provider Name | Jacqueline Mogusu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881162527 PECOS PAC ID: 4981942828 Enrollment ID: I20190219000847 |
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