Individual
KELLY J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 500-6200
(713) 500-6264
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
(713) 500-5484
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M2115
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8S3254
BCBS
TX
01
—
P00280370
RAILROAD MEDICARE
TX
Enumeration date
06/13/2006
Last updated
07/15/2007
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