Provider Demographics
NPI:1003448721
Name:SMOCK, HANNAH PEARL (AGACNP)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:PEARL
Last Name:SMOCK
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8430 HATTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3235
Mailing Address - Country:US
Mailing Address - Phone:713-391-7519
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 1501
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2743
Practice Address - Country:US
Practice Address - Phone:713-441-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX872151363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care