| Doctor Name: | BRIAN MENDENHALL |
| NPI Number: | 1306835442 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | K4955 |
| Business Practice Address: | 700 E Marshall Ave Longview, TX - 756015580 |
| Business Phone Number: | 9033152000 |
| Business Fax Number: | |
| Mailing Address: | 303 W Loop 281, Ste 110, Box 321, LONGVIEW |
| State: | TX |
| Postal Code: | 756054444 |
| Phone Number: | 9037570351 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2005 |
| NPI Last Update Date: | 02/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | K4955 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |