Healthcare Provider Details

I. General information

NPI: 1497383343
Provider Name (Legal Business Name): JASMINE MITCHELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19419 GULF FREEWAY SUITE 3 DEPT 200
WEBSTER TX
77598-2809
US

IV. Provider business mailing address

930 FROSTWOOD DR STE 2.200
HOUSTON TX
77024-2450
US

V. Phone/Fax

Practice location:
  • Phone: 281-316-1000
  • Fax: 281-316-0112
Mailing address:
  • Phone: 713-338-4523
  • Fax: 713-338-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberT9186
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberT9186
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: