Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | D1739 | TX |
NPI | 1003209636 |
---|---|
Provider Name | Dr. Billy Don Mitchell |
First Address | Greenville, TX 75402 |
Second Address | Greenville, TX 75402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2015 |
Last Update Date | 06/03/2015 |