MEDICARE: NICOLE WING CHEE TONG-MITCHELL D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OT013615	PA
2	208D00000X	General Practice Physician	5101018207	MI
3	207R00000X	Internal Medicine Physician	P7863	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01261172	OTHER	TX	RAILROAD RETIREMENT MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134351190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE WING CHEE TONG-MITCHELL D.O.

Provider Business Mailing Address
First Line	:	221 N KANSAS ST
Second Line	:	STE. 1501
City	:	EL PASO
State	:	TX
Zip	:	79901-1443
Country	:	US
Telephone Number	:	915-546-9200
Fax Number	:	915-546-9800

Provider Business Practice Location Address
First Line	:	221 N KANSAS ST
Second Line	:	STE. 1501
City	:	EL PASO
State	:	TX
Zip	:	79901-1443
Country	:	US
Telephone Number	:	915-546-9200
Fax Number	:	915-546-9800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	04/07/2015

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Directions to “ NICOLE WING CHEE TONG-MITCHELL D.O.” Practice Location

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