Individual
JASON SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
2100 N HWY 360 STE 1904, GRAND PRAIRIE, TX 75050-1040
(469) 460-7090
(469) 460-7091
Mailing address
402 POST OAK DR, GRAND PRAIRIE, TX 75050-6567
(940) 867-3113
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
214720
TX
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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