Provider Demographics
NPI:1316972136
Name:SIMMANG, CLIFFORD L (MD)
Entity type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:L
Last Name:SIMMANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:16980 DALLAS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1974
Mailing Address - Country:US
Mailing Address - Phone:214-343-8565
Mailing Address - Fax:214-343-3689
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE A321
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-661-3575
Practice Address - Fax:972-233-9120
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG4245208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG13450Medicare UPIN
TX8G0802Medicare PIN
TX8G0803Medicare PIN