Provider Demographics
NPI:1215184866
Name:MERGELE, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MERGELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 FALLS CT
Mailing Address - Street 2:STE 600
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2977
Mailing Address - Country:US
Mailing Address - Phone:830-896-3130
Mailing Address - Fax:830-896-3132
Practice Address - Street 1:109 FALLS CT
Practice Address - Street 2:STE 600
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2977
Practice Address - Country:US
Practice Address - Phone:830-896-3130
Practice Address - Fax:830-896-3132
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103655225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics