Simmetrice Humphrey

Individual provider Active NPI Community/Behavioral Health Agency · Bacliff, TX

NPI 1508369083 · NPPES record last updated Jul 24, 2024

Key facts

NPI
1508369083
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
1215 Avenue E
Bacliff, TX 77518-2520
Phone
(832) 855-1204
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Ann&Agnes Limited Liability Company Current
since Jan 1, 2022
Accepting new patients
Ann&Agnes Limited Liability Company Secured Medical Transport (Van) Current
since Aug 4, 2024
Accepting new patients

Locations

1215 Avenue E
Bacliff, TX 77518
Phone (832) 855-1204

3228 13th Ave N
Texas City, TX 77590

2818 Palmer Hwy
Texas City, TX 77590

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Secured Medical Transport (VAN) 343800000X
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

1215 Avenue E
Bacliff, TX 77518-2520

Mailing address

1215 Avenue E
Bacliff, TX 77518-2520
Phone (832) 855-1204

Other providers in Bacliff, TX

All providers in Bacliff, TX · Community/Behavioral Health Agency in Texas

Sources for this page

Verify at the official NPI Registry.