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NPI Code Detail

MEDICARE: JAMES KIRK SIMONS D.D.S.

MEDICARE: JAMES KIRK SIMONS D.D.S.
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
11223P0221XPediatric Dentistry9122TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G60054-01OTHERTXCHIP ID

General Provider Information

NPI Number : 1437169620
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES KIRK SIMONS D.D.S.
Provider Business Mailing Address
First Line : 2700 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-5421
Country : US
Telephone Number : 512-442-4338
Fax Number : 512-442-6074
Provider Business Practice Location Address
First Line : 2700 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-5421
Country : US
Telephone Number : 512-442-4338
Fax Number : 512-442-6074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 07/09/2007

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