Provider Demographics
NPI:1720375983
Name:MENDEZ, RUBEN (MD)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5090 RICHMOND AVE # 97
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-7402
Mailing Address - Country:US
Mailing Address - Phone:713-298-0395
Mailing Address - Fax:713-486-7201
Practice Address - Street 1:4888 LOOP CENTRAL DR STE 510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2226
Practice Address - Country:US
Practice Address - Phone:713-346-1551
Practice Address - Fax:713-346-1577
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100344022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBP10034402OtherPHYSICIAN IN TRAINING PERMIT