DR. MIMI NGOC BAO LE (NPI# 1073593000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073593000 |
| Entity Type | Individual |
| Full Name | DR. MIMI NGOC BAO LE |
| Other Name | DR. MIMI NGOCBAO LE |
| Credential | OD |
| Practice Address |
4901 S Broadway Ave Tyler TX 75703-1325 |
| Mailing Address |
830 Carriage Drive Tyler TX 75703 |
| Practice Telephone | 9035082498 |
| Practice Fax Number | 9035082500 |
| Mailing Telephone | (903) 316-2092 |
| Mailing Fax Number | 9035082500 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2017-06-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 6783T | TX | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 181592001 | 05 |
| Street Address |
4901 S BROADWAY AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75703-1325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508153347 | Eyeglass World | Technician/Technologist | 4901 S Broadway Ave, Tyler, TX 75703-1325 | 2011-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215335500 | Daniel & Max, LLC | Optometrist | 8988 S Broadway Ave, Suite 116, Tyler, TX 75703 | 2014-12-18 |
| 1093082257 | Mister Eyecare | Optometrist | 4601 S Broadway Ave Ste F22, Tyler, TX 75703-1320 | 2011-11-16 |
| 1801109525 | Jacob Colt West | Optometrist | 2209 Firestone Cir, Tyler, TX 75703-5870 | 2010-07-22 |
| 1740425164 | William Darrell Parker | Optometrist | 1105 Laurelwood Dr, Tyler, TX 75703-3927 | 2008-12-15 |
| 1023260569 | David Michael Johnson | Optometrist | 2756 S Broadway Ave, Tyler, TX 75701-5412 | 2008-10-15 |
| 1194859769 | Vantage Vision P.C. | Optometrist | 4601 S Broadway Ave, F22, Tyler, TX 75703-1307 | 2007-03-15 |
| 1033247598 | Larry M Chism PC | Optometrist | 136 Shelley Drive, Tyler, TX 75701 | 2007-02-28 |
| 1801923701 | Floyd Galloway Betts IIi | Optometrist | 136 Shelley Dr, Tyler, TX 75701-8723 | 2007-02-27 |
| 1679627301 | Eugene Bennett | Optometrist | 4824 S Broadway Ave, Tyler, TX 75703-1312 | 2007-01-22 |
| 1538223532 | Amy A Fisher | Optometrist | 2756 S Broadway Ave., Tyler, TX 75701-5412 | 2006-12-21 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.