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Contact Information

MINDI G KAVANAUGH, OD
725 E VILLA MARIA RD STE 1500
BRYAN, TX77802-5345
 Phone: 979-775-4900
 Fax: 979-775-4949
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Pediatrics

152WP0200X 41 Optometry
Indicates primary specialty

NPI Profile & details for MINDI G KAVANAUGH · (Female)

NPI Number 1811200389
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 07/26/2010
Last updated 10/03/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # 5828T
  • TX Other 5828T OPTOMETY LICENSE NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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