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Individual
DR. THELA D SIMMONS
Active
Individual
DR. THELA D SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1971T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020190701
—
TX
01
—
124055100
S.W. LIFE AND HEALTH
TX
01
—
4628101
AETNA
TX
01
—
80327E
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/25/2006
Last updated
04/18/2011
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