Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G7949 | TX |
NPI | 1982774154 |
---|---|
Provider Name | Sherolyn B Simmons |
First Address | Pasadena, TX 77508-5607 |
Second Address | Pasadena, TX 77504-2117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 20/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0046CC | MEDICARE RPK GROUP # (01) | TX |
8R5710 | BCBS (01) | TX |
D69090 | (02) |