Individual
DR. JASON MAX MENDIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
11680 MONTANA AVE STE C200, EL PASO, TX 79936-1461
(915) 206-5044
Mailing address
12339 CHIANTI DR, EL PASO, TX 79928-8644
(915) 313-6300
(915) 521-2028
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
2205
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2205
TX
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358170402
—
TX
Enumeration date
07/31/2013
Last updated
02/27/2026
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