Provider Demographics
NPI:1902843949
Name:SMITH, TOUSSAINT (MD)
Entity Type:Individual
Prefix:DR
First Name:TOUSSAINT
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 TOWN CENTER BLVD SOUTH
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-491-6808
Mailing Address - Fax:281-491-6801
Practice Address - Street 1:3527 TOWN CENTER BLVD SOUTH
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-491-6808
Practice Address - Fax:281-491-6801
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8496207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037703803Medicaid
TX037703814Medicaid
TX1902843949OtherBLUE CROSS BLUE SHIELD
TX037703808Medicaid
TXP01254985OtherMEDICARE RR
TX037703814Medicaid
TX037703808Medicaid
TX279765YMVQMedicare PIN
TX279765YQ64Medicare PIN