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General NPI Number Information
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NPI Number | 1063385466
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Entity Type | Organization
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Legal Business Name | MERCY MED HEALTH INC
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1518 10TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4405
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Country | US
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Telephone | 940-236-3729
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 136250
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City | FORT WORTH
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State | TX
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Zip | 76136-0250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | THOMAS COOK
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Credential |
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Telephone | 940-282-9216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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