Individual
DR. KELLY T. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L1942
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08534730
—
NM
01
—
101449100
FIRSTCARE COMMERCIAL
TX
05
—
101449101
—
TX
05
—
144792205
—
TX
05
—
144792206
—
TX
05
—
200013870A
—
OK
01
—
81940
PRESBYTERIAN COMMERCIAL
NM
05
—
81940
—
NM
01
—
87410Z
HMO BLUE
TX
01
—
8G7982
BC/BS
TX
01
—
A582
TRIWEST
NM
Enumeration date
10/31/2005
Last updated
01/06/2014
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