Provider Demographics
NPI:1114349354
Name:PHILIP, MERCY
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:PHILIP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP -C
Mailing Address - Street 1:10711 NICOLES PLACE TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2784
Mailing Address - Country:US
Mailing Address - Phone:281-948-3108
Mailing Address - Fax:
Practice Address - Street 1:10711 NICOLES PLACE TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-2784
Practice Address - Country:US
Practice Address - Phone:713-453-9800
Practice Address - Fax:713-453-9801
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0713344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily