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NPI Code Detail

MEDICARE: GEOFFREY WAYNE SIMMONS PT

MEDICARE: GEOFFREY WAYNE SIMMONS PT
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
1225100000XPhysical Therapist1125888TX

General Provider Information

NPI Number : 1942376769
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEOFFREY WAYNE SIMMONS PT
Provider Business Mailing Address
First Line : 3003 N A ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-5304
Country : US
Telephone Number : 432-618-9952
Fax Number : 432-618-9953
Provider Business Practice Location Address
First Line : 3003 N A ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-5304
Country : US
Telephone Number : 432-684-7755
Fax Number : 432-684-7962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 11/26/2018

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