Provider Demographics
NPI:1770067886
Name:SIMMS, THOMAS LEE (CERT HAIR LOSS SPEC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:SIMMS
Suffix:
Gender:M
Credentials:CERT HAIR LOSS SPEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11699 HERO WAY W STE 120
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2226
Mailing Address - Country:US
Mailing Address - Phone:737-757-2050
Mailing Address - Fax:
Practice Address - Street 1:11699 HERO WAY W STE 120
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641
Practice Address - Country:US
Practice Address - Phone:737-757-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management