MEDICARE: SIMMONS & PRICE MANAGEMENT GROUP, LLC

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	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225239932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMMONS & PRICE MANAGEMENT GROUP, LLC

Provider Business Mailing Address
First Line	:	8410 FONDREN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-5616
Country	:	US
Telephone Number	:	713-272-8200
Fax Number	:	713-272-8201

Provider Business Practice Location Address
First Line	:	8410 FONDREN ROAD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-2215
Country	:	US
Telephone Number	:	713-272-8200
Fax Number	:	713-272-8201

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	MR. WESLEY EVAN SIMMONS
Credential	:
Telephone Number	:	713-272-8200

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	03/06/2011

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