Provider Demographics
NPI:1023401981
Name:RODRIGO X MENCHACA
Entity Type:Organization
Organization Name:RODRIGO X MENCHACA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODRIGO
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:MENCHACA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-763-1200
Mailing Address - Street 1:706 DENVER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4140
Mailing Address - Country:US
Mailing Address - Phone:940-763-1200
Mailing Address - Fax:940-763-1207
Practice Address - Street 1:706 DENVER ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4140
Practice Address - Country:US
Practice Address - Phone:940-763-1200
Practice Address - Fax:940-763-1207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0628207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty