Individual
CHARLES H MIMS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4411 MEDICAL DR, SAN ANTONIO, TX 78229-3822
(210) 595-5326
(210) 614-8740
Mailing address
4411 MEDICAL DR, SAN ANTONIO, TX 78229-3832
(210) 595-5326
(210) 614-8740
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
D4230
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D4230
STATE LICESNE
TX
Enumeration date
02/06/2006
Last updated
07/09/2007
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