Individual
JEFFREY T MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAAA
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(254) 202-2000
(254) 202-5849
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
005644
GA
Other
Enumeration date
09/12/2009
Last updated
01/25/2022
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