Individual
BRIAN MENDENHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-2000
Mailing address
303 W LOOP 281, STE 110, BOX 321, LONGVIEW, TX 75605-4444
(903) 757-0351
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K4955
TX
208D00000X
General Practice Physician
K4955
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116408904
—
TX
Enumeration date
10/20/2005
Last updated
03/15/2018
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