Individual
MS. MICAELA MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8200
Mailing address
6515 70TH ST, LUBBOCK, TX 79424-1946
(806) 787-3273
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
958354
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1150307
TX
Other
Enumeration date
11/08/2023
Last updated
03/01/2024
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