Provider Demographics
NPI:1134484983
Name:MERCY FAMILY AND PEDIATRIC CLINIC
Entity Type:Organization
Organization Name:MERCY FAMILY AND PEDIATRIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:O
Authorized Official - Last Name:EKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD DNP APRN FNP-C
Authorized Official - Phone:832-328-8891
Mailing Address - Street 1:12638 BISSONNET ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1479
Mailing Address - Country:US
Mailing Address - Phone:832-328-8891
Mailing Address - Fax:832-478-7911
Practice Address - Street 1:12638 BISSONNET ST STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1479
Practice Address - Country:US
Practice Address - Phone:832-328-8891
Practice Address - Fax:832-478-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service