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Organization

MIMI CHAN, LLC

Active
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Organization

MIMI CHAN, LLC

Active
Other names
Nutrition Comfort, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MIMI CHAN RD, LD, CNSC, CDE (CEO)
(832) 916-2698
Entity
Organization

Contact information

Practice address
515A SOUTH FRY ROAD, SUITE #165, KATY, TX 77450
(832) 916-2698
Mailing address
515A SOUTH FRY ROAD, SUITE 165, KATY, TX 77450

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT83652
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6236760
CIGNA
NY
01
9050926
AETNA
NY
Enumeration date
07/10/2012
Last updated
02/23/2016
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