MEDICARE: DR. MITCHELL D BROOKS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	G7174	TX

General Provider Information

NPI Number	:	1265564173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL D BROOKS M.D.

Provider Business Mailing Address
First Line	:	8333 DOUGLAS AVE
Second Line	:	SUITE 350
City	:	DALLAS
State	:	TX
Zip	:	75225-5845
Country	:	US
Telephone Number	:	214-987-3888
Fax Number	:	214-987-3889

Provider Business Practice Location Address
First Line	:	8333 DOUGLAS AVE
Second Line	:	SUITE 350
City	:	DALLAS
State	:	TX
Zip	:	75225-5845
Country	:	US
Telephone Number	:	214-987-3888
Fax Number	:	214-987-3889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	10/12/2012

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