Individual
MELANIE MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(800) 994-0371
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
456457395
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP006845
STATE LISENCE
GA
Enumeration date
07/29/2008
Last updated
10/17/2025
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