MEDICARE: MAURISSA SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Y00000X	Health Information Specialist/Technologist	00087778	TX

General Provider Information

NPI Number	:	1104708783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURISSA SMITH

Provider Business Mailing Address
First Line	:	3903 WIMBERLEY HOLLOW LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77053-4568
Country	:	US
Telephone Number	:	281-310-7657
Fax Number	:

Provider Business Practice Location Address
First Line	:	3903 WIMBERLEY HOLLOW LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77053-4568
Country	:	US
Telephone Number	:	281-310-7657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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Directions to “ MAURISSA SMITH ” Practice Location

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