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Individual

DIANA MARIA MERCADO-MARMAROSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1013A S WELLS ST, EDNA, TX 77957-4045
(361) 782-7820
(361) 782-5627
Mailing address
1013A S WELLS ST, EDNA, TX 77957-4045
(361) 782-7820
(361) 782-5627

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
BP10036757
TX
207Q00000X
Family Medicine Physician
Primary
P8390
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
332697703
TX
Enumeration date
06/14/2010
Last updated
11/05/2019
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