Healthcare Provider Details

I. General information

NPI: 1467118737
Provider Name (Legal Business Name): HOLLY NANCIE ELIZABETH SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 FANNIN ST STE 2850
HOUSTON TX
77030-1540
US

IV. Provider business mailing address

107-1540 29TH STREET NW
CALGARY AB
T2N4M1
CA

V. Phone/Fax

Practice location:
  • Phone: 713-486-5139
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberBP10073959
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: