Individual
BRANDON COY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5201 HARRY HINES BLVD, DEPT. OF ANESTHESIOLOGY, DALLAS, TX 75235-7708
(214) 590-8329
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-4105
(214) 590-4162
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
696170
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189477601
—
TX
01
—
88593U
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/25/2008
Last updated
09/13/2017
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