Provider Demographics
NPI:1033185178
Name:SMITH, KEVIN RAYNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:RAYNARD
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:25510 INTERSTATE 45 N STE 100
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1376
Mailing Address - Country:US
Mailing Address - Phone:713-795-0600
Mailing Address - Fax:713-795-0862
Practice Address - Street 1:25510 INTERSTATE 45 N STE 100
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1376
Practice Address - Country:US
Practice Address - Phone:713-795-0600
Practice Address - Fax:713-795-0862
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2793207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery