MEDICARE: SMITH & KLEIN, PA

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0015MA	OTHER	TX	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194836999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH & KLEIN, PA

Provider Business Mailing Address
First Line	:	12121 RICHMOND AVE
Second Line	:	SUITE 106
City	:	HOUSTON
State	:	TX
Zip	:	77082-2420
Country	:	US
Telephone Number	:	281-597-8555
Fax Number	:	281-597-8473

Provider Business Practice Location Address
First Line	:	12121 RICHMOND AVE
Second Line	:	SUITE 106
City	:	HOUSTON
State	:	TX
Zip	:	77082-2420
Country	:	US
Telephone Number	:	281-597-8555
Fax Number	:	281-597-8473

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN HERBERT SMITH
Credential	:	MD
Telephone Number	:	281-597-8555

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	01/18/2008

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Directions to “SMITH & KLEIN, PA ” Practice Location

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