MEDICARE: MR. DENNIS PAUL SIMPSON II CHLS

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	1744P3200X	Prosthetics Case Management	647015	TX

General Provider Information

NPI Number	:	1225577794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DENNIS PAUL SIMPSON II CHLS

Provider Business Mailing Address
First Line	:	2401 W KIEST BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75233-2305
Country	:	US
Telephone Number	:	214-403-2653
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 W KIEST BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75233-2305
Country	:	US
Telephone Number	:	214-403-2653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2017
Last Update Date	:	02/17/2017

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