Individual
DR. DONOVAN MITCHELL SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12221 N MO PAC EXPY, AUSTIN, TX 78758-2401
(512) 306-1903
(512) 306-0107
Mailing address
PO BOX 4268, AUSTIN, TX 78765-4268
(512) 306-1903
(512) 306-0107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L6180
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10046385
AMERIGROUP
TX
05
—
158085405
—
TX
05
—
158085406
—
TX
01
—
8V0511
BCBS
TX
01
—
P00935759
RRMCARE THRU HCMS
TX
Enumeration date
03/24/2006
Last updated
04/28/2015
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