Provider Demographics
NPI:1689274441
Name:MITCHELL, STEVEN D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:D
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3211 ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-4409
Mailing Address - Country:US
Mailing Address - Phone:254-662-0774
Mailing Address - Fax:254-662-2690
Practice Address - Street 1:3211 ROBINSON DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-4409
Practice Address - Country:US
Practice Address - Phone:254-662-0774
Practice Address - Fax:254-662-2690
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX439461835N0905X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear