Provider Demographics
NPI:1730642943
Name:SP BEHAVIORAL PLLC
Entity Type:Organization
Organization Name:SP BEHAVIORAL PLLC
Other - Org Name:SIMMONS PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-849-8079
Mailing Address - Street 1:3777 SIENNA PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6015
Mailing Address - Country:US
Mailing Address - Phone:281-849-8079
Mailing Address - Fax:832-529-3246
Practice Address - Street 1:3777 SIENNA PKWY
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6015
Practice Address - Country:US
Practice Address - Phone:281-849-8079
Practice Address - Fax:832-529-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-14
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1114427309OtherNPI
TX1255479887OtherNPI