Provider Demographics
NPI:1679537617
Name:SIMMONS, DAVID WADE (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WADE
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 LINDA DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5631
Mailing Address - Country:US
Mailing Address - Phone:806-358-6360
Mailing Address - Fax:806-358-6360
Practice Address - Street 1:1400 COULTER ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1786
Practice Address - Country:US
Practice Address - Phone:806-356-4620
Practice Address - Fax:806-356-4625
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX267961835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy