Provider Demographics
NPI:1942686035
Name:MITCHELL, MICHAEL CHRISTOPHER (NP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHRISTOPHER
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 N TWIN CITY HWY STE B
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-3851
Mailing Address - Country:US
Mailing Address - Phone:409-722-0026
Mailing Address - Fax:409-729-2783
Practice Address - Street 1:1039 N TWIN CITY HWY STE B
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-3851
Practice Address - Country:US
Practice Address - Phone:409-722-0026
Practice Address - Fax:409-729-2783
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily