Healthcare Provider Details

I. General information

NPI: 1942017389
Provider Name (Legal Business Name): HOPE DENISE SMTIH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOPE DENISE SMTIH-GANDHLE RN

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/28/2024
Certification Date: 12/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 7TH AVE
FORT WORTH TX
76104-2796
US

IV. Provider business mailing address

PO BOX 763172
DALLAS TX
75376-3172
US

V. Phone/Fax

Practice location:
  • Phone: 682-885-4000
  • Fax:
Mailing address:
  • Phone: 469-878-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number678687
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: