Individual
MAURA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, AGACNP-BC
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
(409) 772-5052
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP125136
TX
363LC0200X
Critical Care Medicine Nurse Practitioner
786628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348655701
—
TX
05
—
348655702
—
TX
05
—
348655705
—
TX
01
—
348655706
MEDICAID CSHCN
TX
01
—
8417NW
BCBS
TX
01
—
8664NM
BCBS
TX
Enumeration date
04/21/2014
Last updated
04/03/2018
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