Provider Demographics
NPI:1881150670
Name:SMITH, ADA J
Entity type:Individual
Prefix:
First Name:ADA
Middle Name:J
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 1:6414 ANNUNCIATION ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-2102
Mailing Address - Country:US
Mailing Address - Phone:832-335-0174
Mailing Address - Fax:281-590-5760
Practice Address - Street 1:6414 ANNUNCIATION ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-2102
Practice Address - Country:US
Practice Address - Phone:832-335-0174
Practice Address - Fax:281-590-5760
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty