Provider Demographics
NPI:1427381854
Name:STEPHANIE D. SMITH-SHAM, M.D., PLLC
Entity Type:Organization
Organization Name:STEPHANIE D. SMITH-SHAM, M.D., PLLC
Other - Org Name:NORTHWEST HOUSTON OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH-SHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACOG
Authorized Official - Phone:281-955-8780
Mailing Address - Street 1:10807 JONES ROAD, #309
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065
Mailing Address - Country:US
Mailing Address - Phone:281-955-8780
Mailing Address - Fax:832-688-8297
Practice Address - Street 1:11302 FALLBROOK DR
Practice Address - Street 2:#302
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4235
Practice Address - Country:US
Practice Address - Phone:281-955-8780
Practice Address - Fax:832-688-8297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2818174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty