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NPI Code Detail

MEDICARE: TALISHA J SMITH

MEDICARE:   TALISHA J 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
1225700000XMassage TherapistMT137206TX
2163WS0121XPlastic Surgery Registered Nurse808230TX

General Provider Information

NPI Number : 1841906310
Entity Type Code : Individual
Provider Name (Legal Business Name) : TALISHA J SMITH
Provider Business Mailing Address
First Line : 20114 SORIA SPRINGS CIR
Second Line :
City : CYPRESS
State : TX
Zip : 77433-8202
Country : US
Telephone Number : 832-306-1804
Fax Number :
Provider Business Practice Location Address
First Line : 2706 ISABELLA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-5446
Country : US
Telephone Number : 281-306-3388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2023
Last Update Date : 01/26/2023

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Directions to “ TALISHA J SMITH ” Practice Location

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