1467118737 NPI number — HOLLY NANCIE ELIZABETH SMITH MD

Table of content: HOLLY NANCIE ELIZABETH SMITH MD (NPI 1467118737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467118737 NPI number — HOLLY NANCIE ELIZABETH SMITH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
HOLLY
Provider Middle Name:
NANCIE ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1467118737
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
107-1540 29TH STREET NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CALGARY
Provider Business Mailing Address State Name:
AB
Provider Business Mailing Address Postal Code:
T2N4M1
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6400 FANNIN ST STE 2850
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-1540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-486-5139
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/11/2021

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: 208600000X , with the licence number:  BP10073959 , 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)





Copyright © 2007-2025 www.npivalidator.com