Provider Demographics
NPI:1619925195
Name:SIMS, JERRY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:A
Last Name:SIMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1015 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4052
Mailing Address - Country:US
Mailing Address - Phone:281-332-0073
Mailing Address - Fax:281-557-5837
Practice Address - Street 1:1015 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 2100
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4052
Practice Address - Country:US
Practice Address - Phone:281-332-0073
Practice Address - Fax:281-557-5837
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2008-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK16194207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE68781Medicare UPIN