Organization
MIMI'S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAT CANTER BRENNER (OWNER/OPERATOR)
(512) 470-5943
Entity
Organization
Contact information
Practice address
12636 RESEARCH BLVD, SUITE C 109, AUSTIN, TX 78759-2200
(512) 470-5943
(512) 231-1182
Mailing address
12636 RESEARCH BLVD, SUITE C 109, AUSTIN, TX 78759-2200
(512) 470-5943
(512) 231-1182
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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