MEDICARE: GREGORY EARL SIMS

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	332B00000X	Durable Medical Equipment & Medical Supplies	92002	TX

General Provider Information

NPI Number	:	1649360074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY EARL SIMS

Provider Business Mailing Address
First Line	:	14106 COVENANT SPRINGS CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-4428
Country	:	US
Telephone Number	:	281-452-0853
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 BENMAR DR
Second Line	:	SUITE 1175
City	:	HOUSTON
State	:	TX
Zip	:	77060-3165
Country	:	US
Telephone Number	:	832-309-5732
Fax Number	:

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

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	07/08/2007

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