Provider Demographics
NPI:1659308450
Name:MITCHELL, DANA FAYE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:FAYE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 NORTH LOOP W STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1094
Mailing Address - Country:US
Mailing Address - Phone:713-866-6201
Mailing Address - Fax:
Practice Address - Street 1:2525 NORTH LOOP W STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1094
Practice Address - Country:US
Practice Address - Phone:713-866-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024951207R00000X
TXM4361207RN0300X
AL00026053207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM4361OtherSTATE OF TEXAS