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General NPI Number Information
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NPI Number | 1609933613
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Entity Type | Individual
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Provider Name | CHAD ALLEN SMITH CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 4301 VISTA RD.
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City | PASADENA
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State | TX
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Zip | 77504-2117
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Country | US
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Telephone | 713-378-3050
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Fax | 713-378-3077
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Provider Business Mailing Address
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Address Line | 4301 VISTA RD
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City | PASADENA
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State | TX
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Zip | 77504-2117
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Country | US
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Telephone | 713-378-3050
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Fax | 713-378-3077
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 628933
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License Number State | TX
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