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General NPI Number Information
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NPI Number | 1518088491
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Entity Type | Organization
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Legal Business Name | RONNIE MITCHELL,D.O, P.A
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 3200 LONG PRAIRIE RD STE 100
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City | FLOWER MOUND
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State | TX
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Zip | 75022-4962
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Country | US
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Telephone | 972-355-3771
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Fax | 972-539-0066
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Provider Business Mailing Address
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Address Line | 3200 LONG PRAIRIE RD STE 100
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City | FLOWER MOUND
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State | TX
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Zip | 75022-4962
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Country | US
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Telephone | 972-355-3771
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Fax | 972-539-0066
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONNIE MITCHELL
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Credential | D.O.
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Telephone | 972-355-3771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | K 1566
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License Number State | TX
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