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General NPI Number Information
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NPI Number | 1427381854
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Entity Type | Organization
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Legal Business Name | STEPHANIE D. SMITH-SHAM, M.D., PLLC
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 11302 FALLBROOK DR #302
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City | HOUSTON
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State | TX
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Zip | 77065-4235
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Country | US
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Telephone | 281-955-8780
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Fax | 832-688-8297
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Provider Business Mailing Address
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Address Line | 10807 JONES ROAD, #309
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City | HOUSTON
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State | TX
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Zip | 77065
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Country | US
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Telephone | 281-955-8780
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Fax | 832-688-8297
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. STEPHANIE D. SMITH-SHAM
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Credential | M.D., FACOG
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Telephone | 281-955-8780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | N2818
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License Number State | TX
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