Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 8646 | TX |
NPI | 1164570719 |
---|---|
Provider Name | Mrs. Sabrena Simmons |
First Address | Houston, TX 77074-1620 |
Second Address | Houston, TX 77074-1620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |