Provider Demographics
NPI:1740699917
Name:SIMMONDS, MAUREEN JANET (PT, PHD)
Entity type:Individual
Prefix:PROF
First Name:MAUREEN
Middle Name:JANET
Last Name:SIMMONDS
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11218 WOODWATERS WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1954
Mailing Address - Country:US
Mailing Address - Phone:713-306-2073
Mailing Address - Fax:
Practice Address - Street 1:11218 WOODWATERS WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1954
Practice Address - Country:US
Practice Address - Phone:713-306-2073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1094696225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist