Healthcare Provider Details

I. General information

NPI: 1083040141
Provider Name (Legal Business Name): ANALIZA MITCHELL D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 06/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 SOUTHWEST FWY STE 165
HOUSTON TX
77074-2096
US

IV. Provider business mailing address

PO BOX 4839
TROY MI
48099-4839
US

V. Phone/Fax

Practice location:
  • Phone: 713-988-1398
  • Fax: 877-474-7351
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2071
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number2071
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: