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NPI Code Detail

MEDICARE: MS. BOBBIE DEE SIMS MED, ATC, LAT

MEDICARE: MS. BOBBIE DEE SIMS MED, ATC, LAT
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
12255A2300XAthletic TrainerAT2784TX
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1912123977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BOBBIE DEE SIMS MED, ATC, LAT
Provider Business Mailing Address
First Line : 612 E LAMAR BLVD
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-4121
Country : US
Telephone Number : 903-910-8878
Fax Number :
Provider Business Practice Location Address
First Line : 612 E LAMAR BLVD
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-4121
Country : US
Telephone Number : 903-910-8878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 03/19/2021

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