Individual
DR. TIMOTHY A. MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
K2965
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1222903-05
—
TX
01
—
1222903-06
CSHCN
TX
01
—
8J0634
BLUE SHIELD
TX
01
—
P00034512
RR/MEDICARE
TX
Enumeration date
03/27/2006
Last updated
01/25/2022
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