Provider Demographics
NPI:1306872353
Name:SIM, TOMMY CHUA (MD)
Entity type:Individual
Prefix:
First Name:TOMMY
Middle Name:CHUA
Last Name:SIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 E PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5147
Mailing Address - Country:US
Mailing Address - Phone:281-992-3274
Mailing Address - Fax:281-992-3672
Practice Address - Street 1:357 E PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5147
Practice Address - Country:US
Practice Address - Phone:281-992-3274
Practice Address - Fax:281-992-3672
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3753207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123931101Medicaid
TX00T64FMedicare ID - Type Unspecified
TX123931101Medicaid