# MENDIVIL CLINIC FOR FOOT & ANKLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mendivil Clinic for Foot and Ankle Surgery and Regenerative Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396524054
- **Authorized official:** JASON MENDIVIL DPM (OWNER)
- **Authorized official phone:** (915) 309-0513

## Contact information

- **Practice address:** 11680 MONTANA AVE STE C200, EL PASO, TX 79936-1461
- **Practice address phone:** (915) 206-5044
- **Practice address fax:** (915) 519-4671
- **Mailing address:** 12339 CHIANTI DR, EL PASO, TX 79928-8644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0102X | Surgical Critical Care Physician | — | NULL | — |
| 2086S0102X | Surgical Critical Care Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/22/2023
- **Last updated:** 02/27/2026