Provider Demographics
NPI:1205041860
Name:MARCUS DARNELL SMITH
Entity Type:Organization
Organization Name:MARCUS DARNELL SMITH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNIST HOSPITALIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:DARNELL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:281-465-4555
Mailing Address - Street 1:6700 WOODLANDS PARKWAY
Mailing Address - Street 2:SUITE 230-312
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2575
Mailing Address - Country:US
Mailing Address - Phone:281-465-4555
Mailing Address - Fax:281-298-2456
Practice Address - Street 1:6700 WOODLANDS PARKWAY
Practice Address - Street 2:SUITE 230-312
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2575
Practice Address - Country:US
Practice Address - Phone:281-465-4555
Practice Address - Fax:281-298-2456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0278207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y235Medicare PIN