Individual
SHAUN SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6410 FANNIN ST STE 1014, HOUSTON, TX 77030-5301
(832) 325-7080
(713) 512-2239
Mailing address
6431 FANNIN STREET, MSB 7.005B, HOUSTON, TX 77030
(713) 500-7570
(713) 500-0660
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
R1657
TX
2084N0600X
Clinical Neurophysiology Physician
Primary
R1657
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8GN641
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/25/2007
Last updated
01/05/2024
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