Provider Demographics
NPI:1750620175
Name:SMITH, RAQISHA
Entity type:Individual
Prefix:MS
First Name:RAQISHA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7634 CLARENDON BEND LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2391
Mailing Address - Country:US
Mailing Address - Phone:281-814-4962
Mailing Address - Fax:281-239-3112
Practice Address - Street 1:7634 CLARENDON BEND LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2391
Practice Address - Country:US
Practice Address - Phone:281-814-4962
Practice Address - Fax:281-239-3112
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion