Provider Demographics
NPI:1922296003
Name:SIMLIN, BOBBIE J (NP)
Entity Type:Individual
Prefix:MRS
First Name:BOBBIE
Middle Name:J
Last Name:SIMLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:BOBBIE
Other - Middle Name:J
Other - Last Name:SIMIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:850 CENTRAL PKWY E
Mailing Address - Street 2:275
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5561
Mailing Address - Country:US
Mailing Address - Phone:972-668-5400
Mailing Address - Fax:
Practice Address - Street 1:850 CENTRAL PKWY E
Practice Address - Street 2:275
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5561
Practice Address - Country:US
Practice Address - Phone:972-668-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-14
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA206105301Medicaid
TXD07564OtherMEDICARE RR PALMETTO
TXDQ5280OtherMEDICARE RR PALMETTO
TX206105302Medicaid
TX8L11904Medicare PIN
TXTXB100866Medicare PIN
TXTXB102633Medicare PIN