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General NPI Number Information
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NPI Number | 1770831034
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Entity Type | Organization
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Legal Business Name | MERCER DURABLE MEDICAL EQUIPMENT, LLC
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 2806 JESSICA LN
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City | LUCAS
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State | TX
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Zip | 75002-3703
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Country | US
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Telephone | 469-323-5474
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Fax |
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Provider Business Mailing Address
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Address Line | 7155 OLD KATY RD SUITE S268
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City | HOUSTON
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State | TX
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Zip | 77024-2134
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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 | OWNER
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Name | MICHELLE WILSON
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Credential |
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Telephone | 469-323-5474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1000967
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License Number State | TX
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