Healthcare Provider Details

I. General information

NPI: 1932758042
Provider Name (Legal Business Name): ELIZABETH KAY SMITH FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10934 EAST FWY
HOUSTON TX
77029-1912
US

IV. Provider business mailing address

10934 EAST FWY
HOUSTON TX
77029-1912
US

V. Phone/Fax

Practice location:
  • Phone: 832-937-5907
  • Fax: 888-638-6155
Mailing address:
  • Phone: 832-937-5907
  • Fax: 888-638-6155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number802160
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: