MEDICARE: TABOR SMITH D.C. P.A.

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	111N00000X	Chiropractor	10900	TX

General Provider Information

NPI Number	:	1174857205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TABOR SMITH D.C. P.A.

Provider Business Mailing Address
First Line	:	19500 STATE HIGHWAY 249 STE 285
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3024
Country	:	US
Telephone Number	:	281-664-2250
Fax Number	:	281-664-2250

Provider Business Practice Location Address
First Line	:	19500 STATE HIGHWAY 249 STE 285
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3024
Country	:	US
Telephone Number	:	281-664-2250
Fax Number	:	281-664-2250

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. SAMUEL TABOR SMITH
Credential	:	D.C.
Telephone Number	:	281-664-2250

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	09/22/2009

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