Provider Demographics
NPI:1336881903
Name:SMITH, HOUSTON JAMES (DC)
Entity Type:Individual
Prefix:
First Name:HOUSTON
Middle Name:JAMES
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 GRANDE VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3140
Mailing Address - Country:US
Mailing Address - Phone:469-955-1056
Mailing Address - Fax:
Practice Address - Street 1:7920 ACC BLVD STE 120A
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8744
Practice Address - Country:US
Practice Address - Phone:469-955-1056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor