Provider Demographics
NPI:1912151044
Name:SMITH, SHARON ALTHEA (MD)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ALTHEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 NORTH LOOP WEST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018
Mailing Address - Country:US
Mailing Address - Phone:713-697-8555
Mailing Address - Fax:713-697-8551
Practice Address - Street 1:2010 NORTH LOOP WEST
Practice Address - Street 2:SUITE 260
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:713-697-8555
Practice Address - Fax:713-697-8551
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101182207V00000X
NY250935-1207V00000X
TXN2815207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210432501Medicaid
TX8L24701Medicare UPIN