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General NPI Number Information
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NPI Number | 1962554816
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Entity Type | Individual
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Provider Name | JAMES LUTHER MIMS III M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 311 CAMDEN ST SUITE 511
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City | SAN ANTONIO
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State | TX
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Zip | 78215-2012
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Country | US
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Telephone | 210-225-0084
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Fax |
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Provider Business Mailing Address
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Address Line | 311 CAMDEN ST SUITE 511
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City | SAN ANTONIO
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State | TX
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Zip | 78215-2012
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Country | US
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Telephone | 210-225-0084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D 7450
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License Number State | TX
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