Provider Demographics
NPI:1376511154
Name:SIMS, JOHN P (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:SIMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 SOUTH DENTON TAP
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:972-304-9100
Mailing Address - Fax:972-304-9048
Practice Address - Street 1:580 SOUTH DENTON TAP
Practice Address - Street 2:SUITE 100
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019
Practice Address - Country:US
Practice Address - Phone:972-304-9100
Practice Address - Fax:972-304-9048
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1084317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist