Active NPI
Odette Lopez Mercier, LSA
- Surgical Physician Assistant
- Katy, TX
National Provider Identifier
1063929305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 17-657
- Practice address
- 29310 Prairie Rose CT
Katy, TX 77494-7384 - Phone
- (786) 556-8819
- NPI assigned
- Jan 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 17-657 | TX | Primary |
Addresses
Primary practice location
29310 Prairie Rose CT
Katy, TX 77494-7384
Mailing address
29310 Prairie Rose CT
Katy, TX 77494-7384
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17-657 | Other | TX | UHC, BCBS, CIGNA, AEGNA, WC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-657 | TX | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515456000000",
"number": "1063929305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29310 PRAIRIE ROSE CT",
"city": "KATY",
"state": "TX",
"postal_code": "774947384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29310 PRAIRIE ROSE CT",
"city": "KATY",
"state": "TX",
"postal_code": "774947384",
"telephone_number": "786-556-8819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ MERCIER",
"first_name": "ODETTE",
"credential": "LSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-09",
"last_updated": "2018-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TX",
"license": "17-657",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC, BCBS, CIGNA, AEGNA, WC",
"identifier": "17-657",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.