Provider Demographics
NPI:1649360074
Name:SIMS, GREGORY EARL
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:EARL
Last Name:SIMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14106 COVENANT SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-4428
Mailing Address - Country:US
Mailing Address - Phone:281-452-0853
Mailing Address - Fax:
Practice Address - Street 1:440 BENMAR DR
Practice Address - Street 2:SUITE 1175
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3165
Practice Address - Country:US
Practice Address - Phone:832-309-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92002332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies