MEDICARE: ALFRED T. MITCHELL M.D.

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	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	J9214	TX

General Provider Information

NPI Number	:	1730308586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFRED T. MITCHELL M.D.

Provider Business Mailing Address
First Line	:	17625 EL CAMINO REAL
Second Line	:	SUITE 250
City	:	HOUSTON
State	:	TX
Zip	:	77058-3052
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17625 EL CAMINO REAL
Second Line	:	SUITE 250
City	:	HOUSTON
State	:	TX
Zip	:	77058-3052
Country	:	US
Telephone Number	:	281-286-1000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALFRED TENNYSON MITCHELL
Credential	:	M.D.
Telephone Number	:	281-335-0003

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	08/22/2020

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