Healthcare Provider Details

I. General information

NPI: 1245991207
Provider Name (Legal Business Name): JERI CATON SMITH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JERI CATON SMOLA

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20311 KUYKENDAHL RD
SPRING TX
77379-5495
US

IV. Provider business mailing address

1164 BUFFALO RUN
BUFFALO GAP TX
79508-2040
US

V. Phone/Fax

Practice location:
  • Phone: 832-717-3376
  • Fax: 832-717-0004
Mailing address:
  • Phone: 325-665-5347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15465
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: