Provider Demographics
NPI:1629597307
Name:MITCHELL, ELEXIS RAEJOY (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELEXIS
Middle Name:RAEJOY
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BAYLOR PLAZA
Mailing Address - Street 2:MS 390
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-7851
Mailing Address - Fax:713-798-8911
Practice Address - Street 1:7200 CAMBRIDGE ST
Practice Address - Street 2:SUITE 6B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-5700
Practice Address - Fax:713-798-8460
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF06171747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF06171747OtherAPRN LICENSE #