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General NPI Number Information
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NPI Number | 1194540757
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Entity Type | Organization
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Legal Business Name | KEVIN M SMITH ORTHOPAEDICS PLLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 3605 PINE ACRES DR
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City | CONROE
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State | TX
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Zip | 77384-4061
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Provider Business Mailing Address
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Address Line | PO BOX 2550
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City | ROWLETT
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State | TX
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Zip | 75030-2550
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Authorized Official
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Title or Position | OWENER
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Name | KEVIN M SMITH
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Credential | LSA
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Telephone | 214-227-2457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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