Individual
TATJANA MICHELE MIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2813 SMITH RANCH RD, PEARLAND, TX 77584-5254
(832) 582-7146
Mailing address
3975 I 49 S SERVICE RD STE 201, OPELOUSAS, LA 70570-0775
(337) 407-2795
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1193553
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
207499
LA
Other
Enumeration date
09/30/2019
Last updated
01/26/2026
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