Individual
MITCHELL J. FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 GEORGE DIETER DR, #100, EL PASO, TX 79936-7601
(915) 857-4559
Mailing address
1400 GEORGE DIETER DR STE 100, EL PASO, TX 79936-7601
(915) 921-7600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
F9411
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
F9411
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114664904
—
TX
01
—
8M5220
BC/BS OF TEXAS
TX
Enumeration date
06/10/2006
Last updated
06/21/2010
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