person
Jack Mizelle, MD
Student in an Organized Health Care Education/Training Program in Dallas, Texas
NPI 1629710157

Jack Mizelle is a Student in an Organized Health Care Education/Training Program based in Hastings On Hudson, TX. Jack Mizelle practices in Dallas, TX and has the professional credentials of MD. The NPI Number for Jack Mizelle is 1629710157 and holds a License No. (Texas).

The current practice location address for Jack Mizelle is 5323 Harry Hines Blvd Dallas, Dallas, TX and can be reached out via phone at 914-815-4611.

Location: 5323 Harry Hines Blvd Dallas, Dallas, TX, 10706-1438
person
Provider Profile Details
NPI Number
1629710157
Provider Name
Jack Mizelle
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
5323 Harry Hines Blvd Dallas, Dallas, TX, 10706-1438
Phone Number
914-815-4611
Fax Number
Provider Enumeration Date
04/13/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5323 Harry Hines Blvd Dallas
City
State
Zip
75390-0001
Phone Number
914-815-4611
Fax Number
person
Provider Business Mailing Address Details
Address
5323 Harry Hines Blvd Dallas
City
State
Zip
75390-0001
Phone Number
914-815-4611
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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