Individual
DAVID LEON MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1412 ROMA LN, FORT WORTH, TX 76134-2304
(682) 583-4545
Mailing address
1412 ROMA LN, FORT WORTH, TX 76134-2304
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
TX
Other
Enumeration date
05/17/2017
Last updated
06/16/2018
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