Provider Demographics
NPI:1154976025
Name:STEPHEN M. SIMS, MD, PA
Entity type:Organization
Organization Name:STEPHEN M. SIMS, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-756-3464
Mailing Address - Street 1:PO BOX 621004
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75262-1004
Mailing Address - Country:US
Mailing Address - Phone:936-756-3464
Mailing Address - Fax:936-267-2987
Practice Address - Street 1:17189 I 45 S STE 265
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3323
Practice Address - Country:US
Practice Address - Phone:936-647-1469
Practice Address - Fax:936-242-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty