Provider Demographics
NPI:1366400665
Name:SIMS, GINA CHO (MD)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:CHO
Last Name:SIMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-9729
Mailing Address - Fax:214-645-9289
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7208
Practice Address - Country:US
Practice Address - Phone:214-645-9729
Practice Address - Fax:214-645-9289
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK80752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G69686Medicare UPIN
TX86155RMedicare ID - Type Unspecified