Provider Demographics
NPI:1639271778
Name:MERCADO, IVETTE YOLANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:IVETTE
Middle Name:YOLANDA
Last Name:MERCADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14549 EWING DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-2232
Mailing Address - Country:US
Mailing Address - Phone:956-425-3706
Mailing Address - Fax:956-425-6731
Practice Address - Street 1:597 W SESAME DR STE D
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8770
Practice Address - Country:US
Practice Address - Phone:956-425-3706
Practice Address - Fax:956-426-6731
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178986901Medicaid
TX178986901Medicaid