MEDICARE: JAMES MICHELL QMHP

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1679129464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MICHELL QMHP

Provider Business Mailing Address
First Line	:	2017 BRUSHFIRE CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-5678
Country	:	US
Telephone Number	:	682-362-1125
Fax Number	:

Provider Business Practice Location Address
First Line	:	2017 BRUSHFIRE CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-5678
Country	:	US
Telephone Number	:	682-362-1125
Fax Number	:

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

Provider Enumeration Date	:	08/16/2019
Last Update Date	:	05/15/2026

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