MEDICARE: DEENA C SMITH

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1104793538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEENA C SMITH

Provider Business Mailing Address
First Line	:	14231 CHAMPIONSHIP LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-1225
Country	:	US
Telephone Number	:	832-525-6004
Fax Number	:

Provider Business Practice Location Address
First Line	:	14231 CHAMPIONSHIP LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-1225
Country	:	US
Telephone Number	:	832-525-6004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	03/25/2026

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Directions to “ DEENA C SMITH ” Practice Location

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