Provider Demographics
NPI:1639565591
Name:SMITH-GRAZIANI, DEMETRIA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:DEMETRIA
Middle Name:JOY
Last Name:SMITH-GRAZIANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEMETRIA
Other - Middle Name:JOY
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7200 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4202
Mailing Address - Country:US
Mailing Address - Phone:713-798-6098
Mailing Address - Fax:
Practice Address - Street 1:2525 HOLLY HALL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4124
Practice Address - Country:US
Practice Address - Phone:713-566-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2903207R00000X, 207RX0202X, 390200000X
GA92402207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8LZ747OtherBCBS
TX405791102OtherMEDICAID-CSHCN
TX405791101Medicaid