# MID-CITIES MEDICAL INSTITUTE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427296912
- **Authorized official:** DR. CHARLES E WILLIS II M.D. (PRESIDENT)
- **Authorized official phone:** (817) 498-7400

## Contact information

- **Practice address:** 8208 BEDFORD EULESS RD, NORTH RICHLAND HILLS, TX 76180-7214
- **Practice address phone:** (817) 498-7400
- **Practice address fax:** (817) 503-9967
- **Mailing address:** PO BOX 1583, COLLEYVILLE, TX 76034-1583
- **Mailing address phone:** (817) 498-7400
- **Mailing address fax:** (817) 503-9967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | DC6911 | TX | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | J0365 | TX | — |
| 208D00000X | General Practice Physician | MCH-7354 | TX | Yes |

## Other

- **Enumeration date:** 01/22/2009
- **Last updated:** 07/27/2009