Provider Demographics
NPI:1093773624
Name:MARIA CECILIA MITCHELL
Entity Type:Organization
Organization Name:MARIA CECILIA MITCHELL
Other - Org Name:ADAPTIVE MEDICAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:MITHCELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-792-7125
Mailing Address - Street 1:1901 W LOOP 289
Mailing Address - Street 2:STE 3
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407
Mailing Address - Country:US
Mailing Address - Phone:806-792-7125
Mailing Address - Fax:806-792-7121
Practice Address - Street 1:1901 W LOOP 289
Practice Address - Street 2:STE 3
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407
Practice Address - Country:US
Practice Address - Phone:806-792-7125
Practice Address - Fax:806-792-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00431U3332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4998710001Medicare ID - Type Unspecified