Provider Demographics
NPI:1669436655
Name:MITCHELL, MICHAEL R (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:817-684-9970
Mailing Address - Fax:817-684-9373
Practice Address - Street 1:400 W ARBROOK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3176
Practice Address - Country:US
Practice Address - Phone:817-784-1238
Practice Address - Fax:817-468-2028
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2019-09-05
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Provider Licenses
StateLicense IDTaxonomies
TXG3616207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137736807Medicaid
TX137736811Medicaid
TX137736807Medicaid
TXB95685Medicare UPIN
TX8293K1Medicare PIN