Individual
MACK MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UT SOUTHWESTERN MEDICAL CTR, 5323 HARRY HINES BLVD, DALLAS, TX 75390-9030
(214) 648-5036
Mailing address
UT SOUTHWESTERN MEDICAL CTR, 5323 HARRY HINES BLVD, DALLAS, TX 75390-9030
(214) 648-5036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N9911
TX
207RG0100X
Gastroenterology Physician
Primary
N9911
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
316941300
—
MD
Enumeration date
05/12/2006
Last updated
10/04/2011
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