Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 44274 | TX |
NPI | 1306872270 |
---|---|
Provider Name | Dr. Ron Benson Mitchell |
First Address | Dallas, TX 75390-7201 |
Second Address | Dallas, TX 75235-7701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 26/07/2013 |