Individual
ELLEN S MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4690 SWEETWATER BLVD, ST #200, SUGAR LAND, TX 77479-3467
(281) 565-0033
Mailing address
2723 POLK ST, HOUSTON, TX 77003-4536
(281) 565-0033
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07104
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220482801
—
TX
01
—
845N06
BCBS
TX
Enumeration date
01/24/2011
Last updated
05/20/2013
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