Individual
CARL R MENCKHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 FM 2181, SUITE 50, HICKORY CREEK, TX 75065-7670
(940) 270-8910
Mailing address
2941 LAKE VISTA DR, LEWISVILLE, TX 75067-3801
(972) 899-6666
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
049315
GA
207P00000X
Emergency Medicine Physician
Primary
K3339
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000880547A
—
GA
05
—
043983802
—
TX
01
—
8CA551
BCBS
TX
05
—
G49315
—
SC
Enumeration date
08/30/2006
Last updated
02/24/2015
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