Provider Demographics
NPI:1447239033
Name:SIMS, SHAUGHN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAUGHN
Middle Name:THOMAS
Last Name:SIMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor