Provider Demographics
NPI:1811012198
Name:MITCHELL, RAYFORD BENARD (MD)
Entity type:Individual
Prefix:MR
First Name:RAYFORD
Middle Name:BENARD
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:310 W OAKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4033
Mailing Address - Country:US
Mailing Address - Phone:830-569-8940
Mailing Address - Fax:830-569-8320
Practice Address - Street 1:757 S PANNA MARIA AVE
Practice Address - Street 2:
Practice Address - City:KARNES CITY
Practice Address - State:TX
Practice Address - Zip Code:78118-3808
Practice Address - Country:US
Practice Address - Phone:830-780-3100
Practice Address - Fax:830-780-3130
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM2718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190601802Medicaid
TX8AG750OtherBC/BS TEXAS
TX8F6141Medicare PIN
TX190601802Medicaid