Individual
MRS. JUDY JEAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
3370 S TEXAS AVE, SUITE B, BRYAN, TX 77802-3127
(979) 595-1700
(979) 595-1740
Mailing address
1500 UNIVERSITY DR E, SUITE 100, COLLEGE STATION, TX 77840-2600
(979) 846-1100
(979) 260-9390
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
236265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000951607
—
TX
05
—
000951608
—
TX
01
—
1275620551
NPI CLINIC R
TX
01
—
1275726853
NPI CLINIC CS
TX
05
—
154467801
—
TX
05
—
154467803
—
TX
01
—
1568519122
NPI CLINIC L
TX
01
—
1649265646
NPI CLINIC B
TX
01
—
1700973187
NPI CLINIC G
TX
01
—
1750470084
NPI CLINIC M
TX
01
—
1821185299
NPI AGENCY
TX
05
—
185649401
—
TX
05
—
187842301
—
TX
01
—
741715140
TAX ID
TX
01
—
8Y0114
BLUE CROSS
TX
Enumeration date
10/26/2006
Last updated
07/10/2013
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