Provider Demographics
NPI:1942351895
Name:DRS SIMMONS AND SIMMONS, PA
Entity Type:Organization
Organization Name:DRS SIMMONS AND SIMMONS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:H
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-665-0771
Mailing Address - Street 1:1324 N BANKS ST
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-4106
Mailing Address - Country:US
Mailing Address - Phone:806-665-0771
Mailing Address - Fax:806-665-3511
Practice Address - Street 1:1324 N BANKS ST
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-4106
Practice Address - Country:US
Practice Address - Phone:806-665-0771
Practice Address - Fax:806-665-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0650280001Medicare NSC
TX00E57GMedicare PIN