Organization
EL MERCADO ENT & ALLERGY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT R SOMERVILLE M.D. (MEDICAL DIRECTOR)
(512) 842-8011
Entity
Organization
Contact information
Practice address
15520 RANCH ROAD 12, WIMBERLEY, TX 78676-6204
(512) 842-8011
(512) 842-3018
Mailing address
PO BOX 1308, LA FERIA, TX 78559-1308
(512) 842-8011
(512) 842-3018
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D4450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083734601
—
TX
Enumeration date
01/18/2007
Last updated
02/27/2012
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