1174551980 NPI number — DR. DENNIS M. MONELL SMITH D.C.

Table of content: DR. DENNIS M. MONELL SMITH D.C. (NPI 1174551980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174551980 NPI number — DR. DENNIS M. MONELL SMITH D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
DENNIS M.
Provider Middle Name:
MONELL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174551980
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10694 JONES RD
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77065-4278
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-890-2225
Provider Business Mailing Address Fax Number:
281-890-2625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10694 JONES RD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77065-4278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-890-2225
Provider Business Practice Location Address Fax Number:
281-890-2625
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5225 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8A7036 . This is a "BCBS PROVIDER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5225 . This is a "DOCTOR OF CHIROPRACTIC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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