# UTMB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063821981
- **Authorized official:** MS. SANDRA K SMOCK APN (PROVIDER)
- **Authorized official phone:** (281) 269-6700

## Contact information

- **Practice address:** 12603 SOUTHWEST FWY STE 335, STAFFORD, TX 77477-3842
- **Practice address phone:** (281) 269-6700
- **Practice address fax:** (281) 265-5163
- **Mailing address:** 12603 SOUTHWEST FWY STE 335, STAFFORD, TX 77477-3842
- **Mailing address phone:** (281) 269-6700
- **Mailing address fax:** (281) 265-5163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | 233196 | TX | Yes |

## Other

- **Enumeration date:** 08/05/2014
- **Last updated:** 08/05/2014