Provider Demographics
NPI:1750795191
Name:MERCER, DONNA SUSAN (PT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:SUSAN
Last Name:MERCER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:SUSAN
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1103 YUCCA DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79108-3709
Mailing Address - Country:US
Mailing Address - Phone:806-206-7549
Mailing Address - Fax:
Practice Address - Street 1:1103 YUCCA DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79108-3709
Practice Address - Country:US
Practice Address - Phone:806-206-7549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist