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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811200389 NPPES
Texas Other 5828T OPTOMETY LICENSE NUMBER

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