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General NPI Number Information
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NPI Number | 1386828655
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Entity Type | Individual
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Provider Name | TESSA EVETT SMITH M.D
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Gender | Female
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Dates
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Enumeration Date | 12/22/2007
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Last Update Date | 07/28/2013
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Provider Practice Location Address
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Address Line | 607 OAKLEY ST UNIT 1
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City | HOUSTON
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State | TX
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Zip | 77006-5976
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Country | US
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Telephone | 912-441-2982
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Fax |
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Provider Business Mailing Address
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Address Line | 607 OAKLEY ST UNIT 1
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City | HOUSTON
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State | TX
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Zip | 77006-5976
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Country | US
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Telephone | 912-441-2982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 002227
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | N2816
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License Number State | TX
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