Basic Information
| Provider Information | |||||||||
| NPI: | 1467919803 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMMS | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | ALBERT | ||||||||
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| Credential: | MOT, OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 819 PARKVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752231551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142055639 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1900 N FRANCES ST | ||||||||
| Address2: | |||||||||
| City: | TERRELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751601215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725242503 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2019 | ||||||||
| LastUpdateDate: | 02/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 112566 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.