Provider Demographics
NPI:1912319872
Name:MERCER, PATRICIA (LAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:MERCER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:PO BOX 40463
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-0008
Mailing Address - Country:US
Mailing Address - Phone:512-774-7111
Mailing Address - Fax:
Practice Address - Street 1:8701 SHOAL CREEK BLVD STE 302
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-6809
Practice Address - Country:US
Practice Address - Phone:512-774-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist