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NPI Code Detail

MEDICARE: ERICA MITCHELL PA-C

MEDICARE: ERICA MITCHELL PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1366895278
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA MITCHELL PA-C
Provider Business Mailing Address
First Line : 15923 SPRING FOREST DR
Second Line :
City : HOUSTON
State : TX
Zip : 77059-3810
Country : US
Telephone Number : 214-418-3573
Fax Number :
Provider Business Practice Location Address
First Line : 2060 SPACE PARK DR STE 410
Second Line :
City : HOUSTON
State : TX
Zip : 77058-3676
Country : US
Telephone Number : 832-783-2330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2016
Last Update Date : 04/26/2024

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