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NPI Code Detail

MEDICARE: DR. AVIS M SMITH ED. D

MEDICARE: DR. AVIS M SMITH ED. D
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
1101YP2500XProfessional Counselor68239TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174902324
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AVIS M SMITH ED. D
Provider Business Mailing Address
First Line : 77 SUGAR CREEK CENTER BLVD STE 600
Second Line :
City : SUGAR LAND
State : TX
Zip : 77478-3688
Country : US
Telephone Number : 832-384-4357
Fax Number :
Provider Business Practice Location Address
First Line : 77 SUGAR CREEK CENTER BLVD STE 600
Second Line :
City : SUGAR LAND
State : TX
Zip : 77478-3688
Country : US
Telephone Number : 832-384-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2015
Last Update Date : 06/19/2019

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Directions to “ DR. AVIS M SMITH ED. D” Practice Location

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