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NPI Code Detail

MEDICARE: ETHAN MERCADO DPT

MEDICARE: ETHAN MERCADO DPT
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
12251X0800XOrthopedic Physical Therapist1407931TX

General Provider Information

NPI Number : 1447106323
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETHAN MERCADO DPT
Provider Business Mailing Address
First Line : 12418 SHOREBRIDGE RD
Second Line :
City : CYPRESS
State : TX
Zip : 77433-2402
Country : US
Telephone Number : 713-270-5900
Fax Number : 713-270-5910
Provider Business Practice Location Address
First Line : 7575 SAN FELIPE ST STE 125
Second Line :
City : HOUSTON
State : TX
Zip : 77063-1776
Country : US
Telephone Number : 713-270-5900
Fax Number : 713-270-5910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ ETHAN MERCADO DPT” Practice Location

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