Provider Demographics
NPI:1508078999
Name:MITCHELL, II, JOHN HARDING (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HARDING
Last Name:MITCHELL, II
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12935 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-5603
Mailing Address - Country:US
Mailing Address - Phone:713-728-9200
Mailing Address - Fax:713-728-1235
Practice Address - Street 1:12935 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-5603
Practice Address - Country:US
Practice Address - Phone:713-728-9200
Practice Address - Fax:713-728-1235
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601606Medicare ID - Type UnspecifiedBC BS PROVIDER NUMBER