Provider Demographics
NPI:1669826483
Name:MITCHELL, JASMINE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6954 FLAMINGO DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-6612
Mailing Address - Country:US
Mailing Address - Phone:346-245-4510
Mailing Address - Fax:
Practice Address - Street 1:6954 FLAMINGO DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-6612
Practice Address - Country:US
Practice Address - Phone:346-245-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
147131225700000X
376J00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist