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General NPI Number Information
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NPI Number | 1134540560
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Entity Type | Individual
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Provider Name | TOMMY KENT SIMS PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 205 E LAVIELLE ST
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City | KIRBYVILLE
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State | TX
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Zip | 75956-2119
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Country | US
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Telephone | 404-232-2117
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Fax | 409-423-2421
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Provider Business Mailing Address
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Address Line | 205 E LAVIELLE ST
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City | KIRBYVILLE
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State | TX
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Zip | 75956-2119
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Country | US
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Telephone | 404-232-2117
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Fax | 409-423-2421
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01168
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License Number State | TX
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