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
Fax: (903) 508-2500
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073593000 NPPES
Texas MEDICAID 181592001

Popular Providers