=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801844352
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAHALIA D. SMITH, MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2006
-----------------------------------------------------
Last Update Date | 09/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1333 MOURSUND ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-3408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-797-5965
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 14024
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77221-4024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-482-5192
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MAHALIA DOROTHY SMITH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 281-968-9141
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | J7289
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------