Mendivil, Jason Max
Mendivil, Jason Max is an sole proprietor health care provider with primary practice located at 11680 Montana Ave Ste C200 , El Paso TX 79936-1461. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Suppliers / Prosthetic/Orthotic Supplier, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Suppliers / Durable Medical Equipment & Medical Supplies. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Mendivil, Jason Max can be contacted via phone (915) 206-5044.Contact Information
Primary practice address
11680 Montana Ave Ste C200
El Paso TX 79936-1461
Phone: (915) 206-5044
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 2205 | Texas |
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | ||
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 2205 | Texas |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
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 | Feb 27th, 2026 - about 9 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790117893 | NPPES |
| Texas | MEDICAID | 358170402 |
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