Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5599 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 5599 | TX |
NPI | 1053346700 |
---|---|
Provider Name | Dr. Michael Vernon Smith |
First Address | Houston, TX 77058-2627 |
Second Address | Houston, TX 77058-2627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/09/2008 |