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Individual
DR. SALLY MINA
Active
Individual
DR. SALLY MINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O. D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8802TG
TX
152W00000X
Optometrist
TA2254
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8802TG
TEXAS BOARD OF OPTOMETRY
TX
01
—
TA2254
MARYLAND LICENSE NUMBER
MD
Enumeration date
07/29/2011
Last updated
02/25/2025
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