Healthcare Provider Details

I. General information

NPI: 1831920834
Provider Name (Legal Business Name): LAKISHA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 SPENCER HWY
PASADENA TX
77504-1110
US

IV. Provider business mailing address

3550 SPENCER HWY
PASADENA TX
77504-1110
US

V. Phone/Fax

Practice location:
  • Phone: 713-944-0023
  • Fax:
Mailing address:
  • Phone: 713-944-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number42070
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: