Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | S5780 | TX |
Y | 208000000X | Pediatrician | S5780 | TX |
NPI | 1316488760 |
---|---|
Provider Name | Adrienne Nicole Smallwood |
First Address | Houston, TX 77002-8963 |
Second Address | Houston, TX 77030-2358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2017 |
Last Update Date | 29/12/2020 |