Provider Demographics
NPI:1649786427
Name:MEDICAL CARE INNOVATION, P.C.
Entity type:Organization
Organization Name:MEDICAL CARE INNOVATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MERKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-566-8400
Mailing Address - Street 1:N61W23044 HARRYS WAY
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3995
Mailing Address - Country:US
Mailing Address - Phone:414-566-8400
Mailing Address - Fax:
Practice Address - Street 1:1254 ENCLAVE PARKWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077
Practice Address - Country:US
Practice Address - Phone:888-225-8097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-16
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
TXAP114861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty