Provider Demographics
NPI:1225239932
Name:SIMMONS & PRICE MANAGEMENT GROUP, LLC
Entity Type:Organization
Organization Name:SIMMONS & PRICE MANAGEMENT GROUP, LLC
Other - Org Name:LUPE'S WONDERFUL SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-272-8200
Mailing Address - Street 1:8410 FONDREN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-5616
Mailing Address - Country:US
Mailing Address - Phone:713-272-8200
Mailing Address - Fax:713-272-8201
Practice Address - Street 1:8410 FONDREN ROAD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2215
Practice Address - Country:US
Practice Address - Phone:713-272-8200
Practice Address - Fax:713-272-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2011-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189780301Medicaid
TX184701401Medicaid