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General NPI Number Information
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NPI Number | 1023330214
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Entity Type | Organization
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Legal Business Name | CARL V. MITTEN, D.O., P.A.
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 05/03/2010
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Provider Practice Location Address
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Address Line | 310 FREEPORT ST SUITE B
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City | HOUSTON
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State | TX
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Zip | 77015-2311
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Country | US
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Telephone | 713-453-8531
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Fax | 713-453-1816
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Provider Business Mailing Address
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Address Line | 310 FREEPORT ST SUITE B
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City | HOUSTON
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State | TX
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Zip | 77015-2311
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Country | US
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Telephone | 713-453-8531
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Fax | 713-453-1816
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. CARL VERNON MITTEN
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Credential | DO
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Telephone | 713-453-8531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C9230
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License Number State | TX
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