Individual
JENNA NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
4401 GARTH RD, BAYTOWN, TX 77521-2122
(281) 420-8600
Mailing address
2800 E LEAGUE CITY PKWY APT 413, LEAGUE CITY, TX 77573-1678
(916) 862-5469
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT8636
TX
2255A2300X
Athletic Trainer
2020022274
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020022274
ATHLETIC TRAINER
MO
Enumeration date
01/11/2021
Last updated
09/24/2024
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