Provider Demographics
NPI:1346270410
Name:SCOTT A SIMS PA
Entity Type:Organization
Organization Name:SCOTT A SIMS PA
Other - Org Name:NORTHVIEW CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:936-560-2405
Mailing Address - Street 1:3801 NORTH STREET
Mailing Address - Street 2:SUITE 18
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965
Mailing Address - Country:US
Mailing Address - Phone:936-560-2405
Mailing Address - Fax:936-564-3401
Practice Address - Street 1:3801 NORTH STREET
Practice Address - Street 2:SUITE 18
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965
Practice Address - Country:US
Practice Address - Phone:936-560-2405
Practice Address - Fax:936-564-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7336111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00205VMedicare PIN
U75259Medicare UPIN