Provider Demographics
NPI:1629005715
Name:MITCHELL, DENNIS HOUSTON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:HOUSTON
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2650 VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:UT
Mailing Address - Zip Code:84765-5430
Mailing Address - Country:US
Mailing Address - Phone:435-674-3117
Mailing Address - Fax:435-673-8376
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4503
Practice Address - Country:US
Practice Address - Phone:435-688-2104
Practice Address - Fax:435-628-5308
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT104602-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant