1952875932 NPI number — AIMEE LIN SIMINGTON NP-C

Table of content: AIMEE LIN SIMINGTON NP-C (NPI 1952875932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952875932 NPI number — AIMEE LIN SIMINGTON NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMINGTON
Provider First Name:
AIMEE
Provider Middle Name:
LIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952875932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1039
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGTOWN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76082-1039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-523-5402
Provider Business Mailing Address Fax Number:
817-523-5422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 W HIGHWAY 199
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGTOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76082-2631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-523-5402
Provider Business Practice Location Address Fax Number:
817-523-5422
Provider Enumeration Date:
01/14/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP138806 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PENDING , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: PENDING . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".