Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L6733 | TX |
N | 111NI0900X | Internist | L6733 | TX |
Y | 207RN0300X | Nephrologist | L6733 | TX |
NPI | 1013001288 |
---|---|
Provider Name | Dr. William Evans Mitch |
First Address | Houston, TX 77005-3747 |
Second Address | Houston, TX 77030-3411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 20/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
151757502 | (05) | TX |
B76517 | (02) | TX |