Individual
MISS DE ANNE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNIM
Contact information
Practice address
201 MAIN ST STE 600, FORT WORTH, TX 76102-3110
(817) 368-1980
Mailing address
5201 COMANCHE VISTA TRL, GRANBURY, TX 76049-5377
(817) 368-1980
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4482
CNIM
TX
Enumeration date
11/27/2019
Last updated
06/23/2020
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