Healthcare Provider Details

I. General information

NPI: 1720375983
Provider Name (Legal Business Name): RUBEN MENDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4888 LOOP CENTRAL DR STE 510
HOUSTON TX
77081-2226
US

IV. Provider business mailing address

5090 RICHMOND AVE # 97
HOUSTON TX
77056-7402
US

V. Phone/Fax

Practice location:
  • Phone: 713-346-1551
  • Fax: 713-346-1577
Mailing address:
  • Phone: 713-298-0395
  • Fax: 713-486-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberBP10034402
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: