Provider Demographics
NPI:1639590482
Name:MERRITT, VIVIN EARL JR (M D, F A C S)
Entity Type:Individual
Prefix:DR
First Name:VIVIN
Middle Name:EARL
Last Name:MERRITT
Suffix:JR
Gender:M
Credentials:M D, F A C S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 MERRITT RANCH RD
Mailing Address - Street 2:
Mailing Address - City:HARPER
Mailing Address - State:TX
Mailing Address - Zip Code:78631-8001
Mailing Address - Country:US
Mailing Address - Phone:325-446-4866
Mailing Address - Fax:
Practice Address - Street 1:190 MERRITT RANCH RD
Practice Address - Street 2:
Practice Address - City:HARPER
Practice Address - State:TX
Practice Address - Zip Code:78631-8001
Practice Address - Country:US
Practice Address - Phone:325-446-4866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE 1055208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery