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General NPI Number Information
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NPI Number | 1447453543
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Entity Type | Organization
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Legal Business Name | LYNELL SMITH
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 9203 HIGHWAY 6 S STE 124-269
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City | HOUSTON
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State | TX
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Zip | 77083-6386
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Country | US
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Telephone | 281-638-0224
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Fax |
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Provider Business Mailing Address
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Address Line | 9203 HIGHWAY 6 S SUITE 124 BOX 269
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City | HOUSTON
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State | TX
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Zip | 77083-6386
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Country | US
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Telephone | 281-638-0224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LYNELL SMITH
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Credential |
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Telephone | 281-638-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 001008050
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 001008051
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License Number State | TX
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