Provider Demographics
NPI:1003107426
Name:MITCHELL, JANICE LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:LOUISE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4001 LONG PRAIRIE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1535
Mailing Address - Country:US
Mailing Address - Phone:972-420-1470
Mailing Address - Fax:972-420-1465
Practice Address - Street 1:4001 LONG PRAIRIE RD 150
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1535
Practice Address - Country:US
Practice Address - Phone:972-420-1470
Practice Address - Fax:972-420-1465
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2020-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ2931207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX41719ZGZ3Medicare Oscar/Certification