MEDICARE: TOMMY CHUA SIM M.D.

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	207KA0200X	Allergy Physician	H3753	TX

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

General Provider Information

NPI Number	:	1306872353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMMY CHUA SIM M.D.

Provider Business Mailing Address
First Line	:	357 E PARKWOOD AVE
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5147
Country	:	US
Telephone Number	:	281-992-3274
Fax Number	:	281-992-3672

Provider Business Practice Location Address
First Line	:	357 E PARKWOOD AVE
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5147
Country	:	US
Telephone Number	:	281-992-3274
Fax Number	:	281-992-3672

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	03/18/2019

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