Provider Demographics
NPI:1114920808
Name:SMITH, DENISE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:LYNN
Other - Last Name:MALONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:826 HIDDEN CANYON RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3724
Mailing Address - Country:US
Mailing Address - Phone:713-412-4314
Mailing Address - Fax:
Practice Address - Street 1:777 S FRY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2297
Practice Address - Country:US
Practice Address - Phone:281-398-1113
Practice Address - Fax:281-398-1114
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608098OtherBCBS PROVIDER NUMBER
TX7599661OtherAETNA PROVIDER NUMBER
TX7599661OtherAETNA PROVIDER NUMBER