Individual
JOE A MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 N MAGDALEN ST, SAN ANGELO, TX 76903-5400
(325) 658-1511
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
G2558
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110206301
—
TN
Enumeration date
12/09/2005
Last updated
02/29/2016
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