Crystal Beach Medical Clinic LLC
NPI #1114948825 in Crystal Beach, Texas
Provider Information
- NPI Number
- 1114948825
- Entity Type
- Organization
- Organization Name
- Crystal Beach Medical Clinic LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jul 21, 2006
- Last Updated
- Jan 13, 2009
Practice Location
- Address
- 955 S. EAST RD.
- City
- Crystal Beach
- State
- Texas
- ZIP Code
- 77650-1449
- Phone
- (409) 454-2543
Authorized Official
- Name
- MR. BRUCE LEVER MITCHELL, PA-C
- Title
- MEMBER
- Phone
- (409) 454-2543
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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