Provider Demographics
NPI:1780252924
Name:MERCADO, TOMAS (FNP)
Entity type:Individual
Prefix:MR
First Name:TOMAS
Middle Name:
Last Name:MERCADO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2686 W ALTON GLOOR BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-3839
Mailing Address - Country:US
Mailing Address - Phone:956-350-5444
Mailing Address - Fax:
Practice Address - Street 1:1040 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6338
Practice Address - Country:US
Practice Address - Phone:956-350-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1035262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily