Provider Demographics
NPI:1679243000
Name:MERAS, YESSICA
Entity Type:Individual
Prefix:
First Name:YESSICA
Middle Name:
Last Name:MERAS
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 1:2501 W UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79764-7155
Mailing Address - Country:US
Mailing Address - Phone:432-332-0475
Mailing Address - Fax:
Practice Address - Street 1:2501 W UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79764-7155
Practice Address - Country:US
Practice Address - Phone:432-332-9475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician