Provider Demographics
NPI:1194836999
Name:SMITH & KLEIN, PA
Entity Type:Organization
Organization Name:SMITH & KLEIN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-597-8555
Mailing Address - Street 1:12121 RICHMOND AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2420
Mailing Address - Country:US
Mailing Address - Phone:281-597-8555
Mailing Address - Fax:281-597-8473
Practice Address - Street 1:12121 RICHMOND AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2420
Practice Address - Country:US
Practice Address - Phone:281-597-8555
Practice Address - Fax:281-597-8473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0015MAOtherBLUE CROSS BLUE SHIELD
TX174000301Medicaid
TX0015MAOtherBLUE CROSS BLUE SHIELD
TXY21415Medicare UPIN