Provider Demographics
NPI:1568724771
Name:SMITH, KEVIN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1441 WOODSTEAD CT
Mailing Address - Street 2:STE 300
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:281-367-0400
Mailing Address - Fax:281-367-1201
Practice Address - Street 1:1441 WOODSTEAD CT
Practice Address - Street 2:STE 300
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-367-0400
Practice Address - Fax:281-367-1201
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10044122207X00000X
TXR6680207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery