MEDICARE: DR. BRANDY SIMMONS D.C

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	111NP0017X	Pediatric Chiropractor	14887	TX
2	111N00000X	Chiropractor	14887	TX

General Provider Information

NPI Number	:	1659041309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDY SIMMONS D.C

Provider Business Mailing Address
First Line	:	1350 N GREENVILLE AVE APT 4413
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75081-2980
Country	:	US
Telephone Number	:	469-534-9745
Fax Number	:

Provider Business Practice Location Address
First Line	:	18484 PRESTON RD STE 202
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-5475
Country	:	US
Telephone Number	:	469-534-9745
Fax Number	:

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

Provider Enumeration Date	:	09/15/2021
Last Update Date	:	09/15/2021

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Directions to “ DR. BRANDY SIMMONS D.C” Practice Location

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