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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