Provider Demographics
NPI:1134540560
Name:SIMS, TOMMY KENT (PA-C)
Entity type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:KENT
Last Name:SIMS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 E LAVIELLE ST
Mailing Address - Street 2:
Mailing Address - City:KIRBYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75956-2119
Mailing Address - Country:US
Mailing Address - Phone:404-232-2117
Mailing Address - Fax:409-423-2421
Practice Address - Street 1:205 E LAVIELLE ST
Practice Address - Street 2:
Practice Address - City:KIRBYVILLE
Practice Address - State:TX
Practice Address - Zip Code:75956-2119
Practice Address - Country:US
Practice Address - Phone:404-232-2117
Practice Address - Fax:409-423-2421
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01168363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant