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General NPI Number Information
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NPI Number | 1821110560
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Entity Type | Organization
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Legal Business Name | DIEGO F. MENCHACA, M.D., P.A.
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 1203 WELBY CT STE 2
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City | LAREDO
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State | TX
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Zip | 78045-1951
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Country | US
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Telephone | 956-795-8300
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Fax | 956-795-8303
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Provider Business Mailing Address
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Address Line | 1203 WELBY CT STE 2
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City | LAREDO
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State | TX
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Zip | 78045-1951
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Country | US
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Telephone | 956-795-8300
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Fax | 956-795-8303
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DIEGO F MENCHACA
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Credential | M.D.
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Telephone | 956-795-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | K4503
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License Number State | TX
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