Provider Demographics
NPI:1265564173
Name:BROOKS, MITCHELL D (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:D
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8333 DOUGLAS AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5845
Mailing Address - Country:US
Mailing Address - Phone:214-987-3888
Mailing Address - Fax:214-987-3889
Practice Address - Street 1:8333 DOUGLAS AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5845
Practice Address - Country:US
Practice Address - Phone:214-987-3888
Practice Address - Fax:214-987-3889
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2012-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG7174207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB87187Medicare UPIN