Provider Demographics
NPI:1407122302
Name:MERCER, ZACHARY CLYDE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:CLYDE
Last Name:MERCER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5932 LOVELL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-5030
Mailing Address - Country:US
Mailing Address - Phone:817-737-6655
Mailing Address - Fax:817-737-5018
Practice Address - Street 1:5932 LOVELL AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-5030
Practice Address - Country:US
Practice Address - Phone:817-737-6655
Practice Address - Fax:817-737-5018
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist