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General NPI Number Information
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NPI Number | 1457093304
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Entity Type | Individual
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Provider Name | MICHAEL T SMITH JR. LVN/LPN BSNC P-ANP
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Gender | Male
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 13003 SHALLOW FALLS LN
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City | PEARLAND
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State | TX
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Zip | 77584-6525
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Country | US
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Telephone | 832-788-7624
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Fax |
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Provider Business Mailing Address
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Address Line | 7205 ALMEDA RD UNIT 300171
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City | HOUSTON
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State | TX
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Zip | 77230-1059
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Country | US
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Telephone | 832-788-7624
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 342112
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 22630966
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 342112
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | A030599
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | A35992
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | A35992
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | A030599
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | L342112
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License Number State | TX
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