Provider Demographics
NPI:1154474823
Name:SIMS, CHAD EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:EDWARD
Last Name:SIMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 E CALTON RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3638
Mailing Address - Country:US
Mailing Address - Phone:956-729-7730
Mailing Address - Fax:
Practice Address - Street 1:707 E CALTON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3638
Practice Address - Country:US
Practice Address - Phone:956-729-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601480OtherBLUE CROSS BLUE SHIELD
TX001250201Medicaid
TX353010800OtherFEDERAL WORK COMP.
TXP00321117OtherRAILROAD MEDICARE
TXT15918Medicare UPIN
TX353010800OtherFEDERAL WORK COMP.