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General NPI Number Information
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NPI Number | 1346648284
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Entity Type | Organization
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Legal Business Name | SMIMS PLLC
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 01/03/2018
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Provider Practice Location Address
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Address Line | 7589 PRESTON RD STE 600
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City | FRISCO
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State | TX
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Zip | 75034-5675
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Country | US
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Telephone | 817-405-0345
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Fax |
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Provider Business Mailing Address
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Address Line | 7589 PRESTON RD STE 600
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City | FRISCO
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State | TX
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Zip | 75034-5675
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Country | US
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Telephone | 817-405-0345
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MRS. SUCHITRA RAO KAMINENI
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Credential | MD
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Telephone | 817-405-0345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | P0418
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | P0418
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | N8163
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | N8163
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | N8163
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | P0418
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | P0418
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | P0418
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | P0418
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License Number State | TX
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