Smith, Stacy Victoria

Smith, Stacy Victoria is an individual health care provider with primary practice located at 17189 Interstate 45 S Ste 675 , Shenandoah TX 77385-3320. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Smith, Stacy Victoria can be contacted via phone (936) 270-3900.

Contact Information

Primary practice address
17189 Interstate 45 S Ste 675 Shenandoah TX 77385-3320
Phone: (936) 270-3900
Fax: (936) 270-3901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X Q3972 Texas

Profile Details

NPI number 1306138235
LBN Legal business name Smith, Stacy Victoria
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2011
Last updated Jan 11th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306138235 NPPES
Texas MEDICAID 358404703
Texas MEDICAID 358404704

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