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NPI Code Detail

MEDICARE: ELISSIA SMITH

MEDICARE: ELISSIA 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
1235Z00000XSpeech-Language Pathologist124021TX

General Provider Information

NPI Number : 1841157484
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISSIA SMITH
Provider Business Mailing Address
First Line : 8101 BOAT CLUB RD STE 240-319
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-3630
Country : US
Telephone Number : 682-498-3928
Fax Number : 214-935-2457
Provider Business Practice Location Address
First Line : 114 SPROLES DR STE 114
Second Line :
City : BENBROOK
State : TX
Zip : 76126-3249
Country : US
Telephone Number : 682-500-1601
Fax Number : 214-935-2457
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2026
Last Update Date : 01/06/2026

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Directions to “ ELISSIA SMITH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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