Kavanaugh, Mindi Greene
Kavanaugh, Mindi Greene is an sole proprietor health care provider with primary practice located at 725 E Villa Maria Rd Ste 1500 , Bryan TX 77802-5345. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Kavanaugh, Mindi Greene can be contacted via phone (979) 775-4900.Contact Information
Primary practice address
725 E Villa Maria Rd Ste 1500
Bryan TX 77802-5345
Phone: (979) 775-4900
Fax: (979) 775-4949
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 5828T | Texas |
Eye and Vision Services Providers / Optometrist | 152W00000X | 5828T | Texas |
Profile Details
NPI number | 1811200389 |
---|---|
LBN Legal business name | Kavanaugh, Mindi Greene |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 26th, 2010 |
Last updated | Oct 3rd, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1811200389 | NPPES |
Texas | Other | 5828T | OPTOMETY LICENSE NUMBER |
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