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General NPI Number Information
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NPI Number | 1548851215
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Entity Type | Individual
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Provider Name | LISA E SIMS PHARM D
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Gender | Female
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 9510 ELLERBE RD
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City | SHREVEPORT
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State | LA
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Zip | 71106-7406
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Country | US
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Telephone | 318-797-3272
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Fax |
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Provider Business Mailing Address
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Address Line | 1824 MILES DR
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City | LONGVIEW
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State | TX
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Zip | 75605-2492
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Country | US
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Telephone | 903-746-5202
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 43922
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License Number State | TX
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