MEDICARE: RUBEN V MENDOZA M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	L1391	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568446748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBEN V MENDOZA M.D., P.A.

Provider Business Mailing Address
First Line	:	1619 S KENTUCKY ST STE A502
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-2277
Country	:	US
Telephone Number	:	806-354-8300
Fax Number	:	806-354-9962

Provider Business Practice Location Address
First Line	:	1619 S KENTUCKY ST STE A502
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-2277
Country	:	US
Telephone Number	:	806-354-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	02/03/2026

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Directions to “ RUBEN V MENDOZA M.D., P.A.” Practice Location

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