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Organization
SMITH COSMETIC SURGERY CENTER
Active
Organization
SMITH COSMETIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN RAYNARD SMITH M.D. (MEDICAL DOCTOR)
(713) 795-0600
Entity
Organization
Contact information
Practice address
6410 FANNIN ST, SUITE 810, HOUSTON, TX 77030-3000
(713) 795-0600
(713) 795-0862
Mailing address
6410 FANNIN ST, SUITE 810, HOUSTON, TX 77030-3000
(713) 795-0600
(713) 795-0862
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
H2793
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033185178
TYPE 1 NPI
TX
01
—
1033274253
OUR NPI FOR PALLADIUM
TX
01
—
3261901
BLUE LINK
TX
01
—
U79H
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/28/2007
Last updated
08/22/2020
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