Provider Demographics
NPI:1003361965
Name:SMITH, ANN KATHRYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:KATHRYN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:KATHRYN
Other - Last Name:MCCRELESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10740 N GESSNER RD STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:800-346-9037
Mailing Address - Fax:800-346-9037
Practice Address - Street 1:4401 COIT RD STE 411
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0520
Practice Address - Country:US
Practice Address - Phone:972-731-7654
Practice Address - Fax:972-731-6226
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7980363A00000X
TXPA11452363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant