Gordon G Mitchell, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

F9832 Issued in TX

Practice address

2700 E 29TH Street
Suite 220
Bryan, TX 77802

Phone

(979) 774-4008

Fax

(979) 774-7893

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cardiac Cath Lab of Bryan College Station, LP

  • Multi-Specialty Clinic/Center
  • Bryan, TX
  • NPI 1114346723
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1740258508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 E 29TH ST",
            "address_2": "SUITE 220",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022531",
            "telephone_number": "979-774-4008",
            "fax_number": "979-731-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E 29TH STREET",
            "address_2": "SUITE 220",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77802",
            "telephone_number": "979-774-4008",
            "fax_number": "979-774-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GORDON",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F9832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128696502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Miller
• Abigail Ruth Mills, MMFT, LMFT ASSOCIATE
• Council Clayton Mills III, M.D.
• Jennifer Minckler, LMFT, LPC
• Heather Minter, LCSW
• Samantha N Mitchell
• Samrah Mobeen, PHARM.D.
• Gloria Moctezuma
• Moeller Home Healthcare LLC
• Wajiha Mohammed, MS

• Cardiovascular Disease Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.