Provider Demographics
NPI:1124413695
Name:MENCHACA, AARON RAYMOND (DDS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:RAYMOND
Last Name:MENCHACA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 E TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7191
Mailing Address - Country:US
Mailing Address - Phone:956-440-8700
Mailing Address - Fax:
Practice Address - Street 1:2102 E TYLER AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7191
Practice Address - Country:US
Practice Address - Phone:956-440-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry