Provider Demographics
NPI:1295772028
Name:MERCAU, ANA M (MD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:MERCAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE B-416
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:214-267-1400
Mailing Address - Fax:214-267-1401
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE B-416
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:214-267-1400
Practice Address - Fax:214-267-1401
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK7455207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8383J1OtherBC/BS
TX042267701Medicaid
TX8383J1OtherBC/BS
TX8383J1Medicare PIN
TX110244578Medicare PIN
TX613019Medicare PIN