MEDICARE: MRS. DANICA K SIMS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1075349	TX

General Provider Information

NPI Number	:	1548264567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANICA K SIMS P.T.

Provider Business Mailing Address
First Line	:	2301 RED BUD LN STE 300
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-9741
Country	:	US
Telephone Number	:	512-248-1200
Fax Number	:	512-248-1203

Provider Business Practice Location Address
First Line	:	2301 RED BUD LN STE 300
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-9741
Country	:	US
Telephone Number	:	512-248-1200
Fax Number	:	512-248-1203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	11/26/2007

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