Provider Demographics
NPI:1417558826
Name:MERCY CLINIC
Entity Type:Organization
Organization Name:MERCY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-731-3704
Mailing Address - Street 1:951 TRISTAR DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-1536
Mailing Address - Country:US
Mailing Address - Phone:832-481-4004
Mailing Address - Fax:
Practice Address - Street 1:951 TRISTAR DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1536
Practice Address - Country:US
Practice Address - Phone:832-481-4004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULTI CULTURAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center