MEDICARE: HEATHER SIMMONS

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	246ZA2600X	Medical Art Specialist/Technologist

General Provider Information

NPI Number	:	1538366695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER SIMMONS

Provider Business Mailing Address
First Line	:	14427 BROOK HOLLOW BLVD
Second Line	:	247
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3826
Country	:	US
Telephone Number	:	210-204-4668
Fax Number	:

Provider Business Practice Location Address
First Line	:	14427 BROOK HOLLOW BLVD
Second Line	:	247
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3826
Country	:	US
Telephone Number	:	210-204-4668
Fax Number	:

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

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	07/08/2007

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Directions to “ HEATHER SIMMONS ” Practice Location

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