Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | M1353 | TX |
N | 2080P0214X | Pediatric Pulmonologist | M1353 | TX |
NPI | 1326192576 |
---|---|
Provider Name | Keely G Smith |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 19/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
173516901 | (05) | TX |
173516902 | (05) | TX |
173516903 | CSHCN (01) | TX |
8W7643 | BCBS (01) | TX |
I31125 | (02) |