Healthcare Provider Details

I. General information

NPI: 1801711999
Provider Name (Legal Business Name): MERCYPATH MOBILE MEDICAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 PRESTON RD STE 2066
PLANO TX
75093-5200
US

IV. Provider business mailing address

1921 PRESTON RD STE 2066
PLANO TX
75093-5200
US

V. Phone/Fax

Practice location:
  • Phone: 862-237-5564
  • Fax:
Mailing address:
  • Phone: 862-237-5564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RACHELLE ST CLORE DESYR
Title or Position: OWNER, MANAGING MEMBER AND AUTHORIZ
Credential: APRN-CNP, FNP-BC, RN
Phone: 862-237-5564