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NPI Code Detail

MEDICARE: MRS. ROXANNE SMITH-BISONG

MEDICARE: MRS. ROXANNE SMITH-BISONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0807XChild & Adolescent Psychiatric/Mental Health Registered Nurse1113192TX

General Provider Information

NPI Number : 1083563845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROXANNE SMITH-BISONG
Provider Business Mailing Address
First Line : 3080 COLLEGE ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77701-4606
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3080 COLLEGE ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77701-4606
Country : US
Telephone Number : 409-212-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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