Provider Demographics
NPI:1598772303
Name:SIMMONS, JONATHAN WILLIAM III (DC FIAMA)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:WILLIAM
Last Name:SIMMONS
Suffix:III
Gender:M
Credentials:DC FIAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 W HIGHWAY 71
Mailing Address - Street 2:SUITE 360
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8300
Mailing Address - Country:US
Mailing Address - Phone:512-288-5322
Mailing Address - Fax:512-288-3680
Practice Address - Street 1:7010 W HIGHWAY 71
Practice Address - Street 2:SUITE 360
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8300
Practice Address - Country:US
Practice Address - Phone:512-288-5322
Practice Address - Fax:512-288-3680
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601976Medicare ID - Type Unspecified
TXU14192Medicare UPIN