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General NPI Number Information
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NPI Number | 1710439484
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Entity Type | Organization
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Legal Business Name | SIMPKE LLC
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 9303 WATER EDGE POINT LANE
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City | HUMBLE
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State | TX
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Zip | 77396
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Country | US
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Telephone | 281-441-1198
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Fax |
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Provider Business Mailing Address
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Address Line | 9303 WATER EDGE POINT LN
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City | HUMBLE
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State | TX
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Zip | 77396-1919
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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 | DOCTOR OF CHIROPRACTIC
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Name | DR. CODY WAYNE SIMPSON
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Credential | D.C.
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Telephone | 281-441-1198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12836
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License Number State | TX
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