MEDICARE: MR. ALLISON G. MERCADEL RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	31693	TX

General Provider Information

NPI Number	:	1366617755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALLISON G. MERCADEL RPH

Provider Business Mailing Address
First Line	:	20333 STATE HIGHWAY 249
Second Line	:	SUITE 450
City	:	HOUSTON
State	:	TX
Zip	:	77070-2643
Country	:	US
Telephone Number	:	281-257-7900
Fax Number	:	281-257-7920

Provider Business Practice Location Address
First Line	:	20333 STATE HIGHWAY 249
Second Line	:	SUITE 450
City	:	HOUSTON
State	:	TX
Zip	:	77070-2643
Country	:	US
Telephone Number	:	281-257-7900
Fax Number	:	281-257-7920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2008
Last Update Date	:	04/25/2008

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