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NPI Code Detail

MEDICARE: MERRIT CHERRY MPAS, MS, PA-C

MEDICARE: MERRIT CHERRY MPAS, MS, PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1760912281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERRIT CHERRY MPAS, MS, PA-C
Provider Business Mailing Address
First Line : 2236 N LOOP 336 W
Second Line :
City : CONROE
State : TX
Zip : 77304-3519
Country : US
Telephone Number : 936-441-2003
Fax Number :
Provider Business Practice Location Address
First Line : 2236 N LOOP 336 W
Second Line :
City : CONROE
State : TX
Zip : 77304-3519
Country : US
Telephone Number : 936-441-2003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2017
Last Update Date : 07/21/2022

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