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General NPI Number Information
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NPI Number | 1104553379
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Entity Type | Individual
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Provider Name | LEVAUGHN SIMS
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Gender | Male
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Dates
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Enumeration Date | 08/06/2022
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 1111 W MOCKINGBIRD LN
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City | DALLAS
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State | TX
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Zip | 75247-5028
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Country | US
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Telephone | 972-489-5552
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Fax |
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Provider Business Mailing Address
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Address Line | 3939 BRIARGROVE LN APT 3105
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City | DALLAS
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State | TX
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Zip | 75287-6353
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Country | US
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Telephone |
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 000000
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 000000
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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