Healthcare Provider Details

I. General information

NPI: 1003736869
Provider Name (Legal Business Name): JAMES CARTERSON MERCADO LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 W CHARLESTON BLVD STE 3AND5
LAS VEGAS NV
89102-1926
US

IV. Provider business mailing address

10454 JOAQUIN FIRE ST
LAS VEGAS NV
89141-9013
US

V. Phone/Fax

Practice location:
  • Phone: 702-877-9511
  • Fax: 702-620-6202
Mailing address:
  • Phone: 702-883-4116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTMPL0001
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: