MEDICARE: JI HYE SIM

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	363LW0102X	Women's Health Nurse Practitioner	783744	TX

General Provider Information

NPI Number	:	1922327733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JI HYE SIM

Provider Business Mailing Address
First Line	:	1416 CAMPBELL RD
Second Line	:	#100
City	:	HOUSTON
State	:	TX
Zip	:	77055-4752
Country	:	US
Telephone Number	:	713-468-3155
Fax Number	:	281-809-7001

Provider Business Practice Location Address
First Line	:	1416 CAMPBELL RD
Second Line	:	#100
City	:	HOUSTON
State	:	TX
Zip	:	77055-4752
Country	:	US
Telephone Number	:	713-468-3155
Fax Number	:	281-809-7001

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

Provider Enumeration Date	:	05/19/2010
Last Update Date	:	10/28/2014

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Directions to “ JI HYE SIM ” Practice Location

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