Provider Demographics
NPI:1033307947
Name:SIMPSON, MYRTLE HALL (HEALTH CARE PROVIDER)
Entity type:Individual
Prefix:MRS
First Name:MYRTLE
Middle Name:HALL
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:HEALTH CARE PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15611 ROSE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-2714
Mailing Address - Country:US
Mailing Address - Phone:281-438-9159
Mailing Address - Fax:281-438-9159
Practice Address - Street 1:15611 ROSE RIDGE CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-2714
Practice Address - Country:US
Practice Address - Phone:281-438-9159
Practice Address - Fax:281-438-9159
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08436750172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver