MEDICARE: JACARA 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	104100000X	Social Worker	117755	TX

General Provider Information

NPI Number	:	1548123185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACARA SMITH

Provider Business Mailing Address
First Line	:	2525 CITY WEST BLVD
Second Line	:	217
City	:	HOUSTON
State	:	TX
Zip	:	77042
Country	:	US
Telephone Number	:	832-570-2669
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 CITYWEST BLVD APT 217
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-3155
Country	:	US
Telephone Number	:	832-570-2669
Fax Number	:

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ JACARA SMITH ” Practice Location

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