Le, Mimi Ngoc Bao
Le, Mimi Ngoc Bao is an sole proprietor health care provider with primary practice located at 4901 S Broadway Ave , Tyler TX 75703-1325. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Le, Mimi Ngoc Bao can be contacted via phone (903) 508-2498.Contact Information
Primary practice address
4901 S Broadway Ave
Tyler TX 75703-1325
Phone: (903) 508-2498
Fax: (903) 508-2500
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 6783T | Texas |
Profile Details
| NPI number | 1073593000 |
|---|---|
| LBN Legal business name | Le, Mimi Ngoc Bao |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Jul 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073593000 | NPPES |
| Texas | MEDICAID | 181592001 |
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