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General NPI Number Information
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NPI Number | 1740509199
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Entity Type | Individual
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Provider Name | TAMMY S MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 1008 N A ST
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City | MIDLAND
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State | TX
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Zip | 79701-3202
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Country | US
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Telephone | 432-288-1681
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Fax | 432-218-8933
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Provider Business Mailing Address
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Address Line | 1008 N A ST 1008 A STREET
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City | MIDLAND
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State | TX
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Zip | 79701-3202
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Country | US
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Telephone | 432-288-1681
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Fax | 432-218-8933
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State | TX
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