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NPI Code Detail

MEDICARE: MICHAEL HENRY SMITH

MEDICARE: MICHAEL HENRY 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
1183500000XPharmacist21641TX

General Provider Information

NPI Number : 1376864397
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL HENRY SMITH
Provider Business Mailing Address
First Line : 1620 S GORDON ST
Second Line :
City : ALVIN
State : TX
Zip : 77511-3460
Country : US
Telephone Number : 281-585-2404
Fax Number :
Provider Business Practice Location Address
First Line : 1620 S GORDON ST
Second Line :
City : ALVIN
State : TX
Zip : 77511-3460
Country : US
Telephone Number : 281-585-2404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2010
Last Update Date : 06/14/2010

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