Provider Demographics
NPI:1144748427
Name:SMOLIK, JESSICA CAPRI (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CAPRI
Last Name:SMOLIK
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 SUMMER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7209
Mailing Address - Country:US
Mailing Address - Phone:281-744-0699
Mailing Address - Fax:
Practice Address - Street 1:600 AUSTIN RD
Practice Address - Street 2:
Practice Address - City:EAGLE LAKE
Practice Address - State:TX
Practice Address - Zip Code:77434-1510
Practice Address - Country:US
Practice Address - Phone:979-234-2551
Practice Address - Fax:979-234-2551
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134783363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care