Provider Demographics
NPI:1376875245
Name:SHAUGHN SIMS DC INCORPORATED
Entity Type:Organization
Organization Name:SHAUGHN SIMS DC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUGHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-365-8888
Mailing Address - Street 1:406 HUTCHINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821-5818
Mailing Address - Country:US
Mailing Address - Phone:325-365-8888
Mailing Address - Fax:325-365-2331
Practice Address - Street 1:406 HUTCHINGS AVE
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821-5818
Practice Address - Country:US
Practice Address - Phone:325-365-8888
Practice Address - Fax:325-365-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty