MEDICARE: ELIZABETH KAY SMITH FNP-BC

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	363LF0000X	Family Nurse Practitioner	802160	TX

General Provider Information

NPI Number	:	1932758042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH KAY SMITH FNP-BC

Provider Business Mailing Address
First Line	:	1120 N LOOP 336 W STE A
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-1156
Country	:	US
Telephone Number	:	346-646-4220
Fax Number	:	713-461-5307

Provider Business Practice Location Address
First Line	:	1120 N LOOP 336 W STE A
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-1156
Country	:	US
Telephone Number	:	346-646-4220
Fax Number	:	713-461-5307

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

Provider Enumeration Date	:	09/11/2019
Last Update Date	:	05/19/2026

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