Van Der Leden, Mimi

Van Der Leden, Mimi is an sole proprietor health care provider with primary practice located at 18425 Champion Forest Dr , Spring TX 77379-3999. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Van Der Leden, Mimi can be contacted via phone (281) 376-4410.

Contact Information

Primary practice address
18425 Champion Forest Dr Spring TX 77379-3999
Fax: (281) 251-7505
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X L1227 Texas

Profile Details

NPI number 1932166741
LBN Legal business name Van Der Leden, Mimi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2006
Last updated Jul 9th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932166741 NPPES
Texas Other 0045JQ BCBS#

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