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General NPI Number Information
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NPI Number | 1700927167
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Entity Type | Individual
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Provider Name | KEVIN G SMITH PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 4203 YOAKUM BLVD STE 170
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City | HOUSTON
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State | TX
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Zip | 77006-5455
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Country | US
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Telephone | 713-795-5151
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Fax | 713-795-5255
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Provider Business Mailing Address
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Address Line | PO BOX 541633
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City | HOUSTON
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State | TX
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Zip | 77254-1633
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Country | US
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Telephone | 713-795-5151
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Fax | 713-795-5255
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2-4835
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License Number State | TX
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