Individual
DR. ANTONIO JOSE MENCHACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
711 W 38TH ST STE E4, AUSTIN, TX 78705-1132
(512) 479-6633
(512) 479-6617
Mailing address
221 ADAMS ST, GEORGETOWN, TX 78628-3680
(714) 337-3459
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
33650
TX
1223G0001X
General Practice Dentistry
9137998-9921
UT
Other
Enumeration date
11/10/2014
Last updated
10/21/2019
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