Individual
MR. JASON THOMAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11043
TX
363AM0700X
Medical Physician Assistant
1834
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373928601
—
TX
05
—
373928602
—
TX
Enumeration date
01/18/2017
Last updated
02/23/2023
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