Individual
JOHN W MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
302 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0200
(512) 218-6330
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
A10176
LA
363AS0400X
Surgical Physician Assistant
Primary
PA13272
TX
363AS0400X
Surgical Physician Assistant
PA2181
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1625795
—
LA
Enumeration date
04/17/2006
Last updated
01/02/2020
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