Provider Demographics
NPI:1134397029
Name:SIMONS, DANNY CHAD (MS PT)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:CHAD
Last Name:SIMONS
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 LONGHILL WAY
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3832
Mailing Address - Country:US
Mailing Address - Phone:469-474-3975
Mailing Address - Fax:469-728-7133
Practice Address - Street 1:1028 LONGHILL WAY
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-3832
Practice Address - Country:US
Practice Address - Phone:469-474-3975
Practice Address - Fax:469-728-7133
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165348701Medicaid
TXU29PMedicare UPIN
TX456643Medicare PIN