Provider Demographics
NPI:1255612099
Name:SIMMONS, NITA GAIL (MEDICO CIRUJANO)
Entity type:Individual
Prefix:
First Name:NITA
Middle Name:GAIL
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MEDICO CIRUJANO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15931 COOLWOOD DR
Mailing Address - Street 2:APT 2064
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-3519
Mailing Address - Country:US
Mailing Address - Phone:646-599-3003
Mailing Address - Fax:
Practice Address - Street 1:15931 COOLWOOD DR
Practice Address - Street 2:APT 2064
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-3519
Practice Address - Country:US
Practice Address - Phone:646-599-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program