Individual
TAKELA SMITH-CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2918 DOGWOOD BLOSSOM TRL, PEARLAND, TX 77581-5035
(832) 633-7962
Mailing address
2918 DOGWOOD BLOSSOM TRL, PEARLAND, TX 77581-5035
(832) 633-7962
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1033007
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033007
BON LICENSE
TX
Enumeration date
05/07/2021
Last updated
05/07/2021
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