Provider Demographics
NPI:1851436240
Name:MERCIER, JUANETTA (MD)
Entity Type:Individual
Prefix:DR
First Name:JUANETTA
Middle Name:
Last Name:MERCIER
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:CITY OF HOUSTON HEALTH & HUMAN SERVICES
Mailing Address - Street 2:PO BOX 88361
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-8861
Mailing Address - Country:US
Mailing Address - Phone:713-794-9104
Mailing Address - Fax:713-798-0803
Practice Address - Street 1:8000 N STADIUM
Practice Address - Street 2:HDHHS
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-794-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2484207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134616506Medicaid
TX00N81TMedicare ID - Type UnspecifiedTRAILBLAZIER