Healthcare Provider Details

I. General information

NPI: 1831823756
Provider Name (Legal Business Name): DONNA CHILDREN'S CARE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 HOOKS AVE
DONNA TX
78537-3341
US

IV. Provider business mailing address

PO BOX 1820
EDINBURG TX
78540-1820
US

V. Phone/Fax

Practice location:
  • Phone: 956-383-7788
  • Fax:
Mailing address:
  • Phone: 956-383-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLAN MERCADO
Title or Position: M.D
Credential: M.D
Phone: 956-383-7788