Individual
JACK MENGES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 SAINT MICHAEL DR, TEXARKANA, TX 75503-2372
(903) 614-1000
Mailing address
6908 SHADOW BRK, TEXARKANA, TX 75503-5444
(903) 223-6933
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K6776
TX
207Q00000X
Family Medicine Physician
K6776
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200021700A
—
TX
Enumeration date
06/27/2006
Last updated
03/17/2025
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