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Individual

DR. MINDA LAO TOLEDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8333 9TH AVENUE, SUITE B, PORT ARTHUR, TX 77642
(409) 729-9200
(409) 729-9235
Mailing address
8333 9TH AVENUE, SUITE B, PORT ARTHUR, TX 77642
(409) 729-9200
(409) 729-9235

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M2487
TX
208000000X
Pediatrics Physician
Primary
M2487
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1417006735
GROUP NPI
TX
05
178296301
TX
05
178296302
TX
05
178297101
TX
01
20-3418877
TAX ID
TX
01
M2487
LIC NO.
TX
Enumeration date
09/20/2005
Last updated
03/07/2023
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