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General NPI Number Information
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NPI Number | 1689283582
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Entity Type | Individual
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Provider Name | MR. ANGEL RAY MERCADO
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Gender | Male
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 320 WESTWAY PL STE 530
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City | ARLINGTON
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State | TX
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Zip | 76018-1000
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Country | US
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Telephone | 817-516-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 707 EVERGREEN FARM DR
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City | TEMPLE
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State | TX
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Zip | 76502-5359
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Country | US
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Telephone | 254-458-4841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 109640
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License Number State | TX
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