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Organization
MERCED FAMILY HEALTH CLINIC
Active
Organization
MERCED FAMILY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN R LLANES APRN,FNP-BC (OWNER)
(956) 225-2625
Entity
Organization
Contact information
Practice address
202 PALMVIEW DR STE 1, PALMVIEW, TX 78572-9394
(956) 225-2625
(956) 598-6069
Mailing address
PO BOX 3371, MISSION, TX 78573-0057
(956) 225-2625
(956) 598-6069
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306843347
JRL NPI
TX
05
—
1391708-22
—
TX
01
—
1639137193
DOC NPI
TX
Enumeration date
11/20/2020
Last updated
12/15/2020
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