Provider Demographics
NPI:1356921209
Name:SIMMONS, JULIE ANN (APRN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 PINE LN
Mailing Address - Street 2:
Mailing Address - City:NEW WAVERLY
Mailing Address - State:TX
Mailing Address - Zip Code:77358-3871
Mailing Address - Country:US
Mailing Address - Phone:936-581-1154
Mailing Address - Fax:
Practice Address - Street 1:12015 LOUETTA RD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1148
Practice Address - Country:US
Practice Address - Phone:281-370-7272
Practice Address - Fax:832-559-8584
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1033931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1033931OtherLICENSE