MR. KENNETH MONDRE SMITH PHYSICIAN ASSISTANT NPI 1669787032

NPI Information

NPI: 1669787032
Provider Name: MR. KENNETH MONDRE SMITH, PHYSICIAN ASSISTANT
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
24124 CINCO VILLAGE CENTER BLVD
SUITE 100
KATY, TX
ZIP 77494
Phone: (281) 693-5698
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MR. Kenneth Mondre Smith, PHYSICIAN ASSISTANT is a medical physician assistant in Katy, TX. MR. Kenneth Mondre Smith, PHYSICIAN ASSISTANT NPI is 1669787032. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

24124 CINCO VILLAGE CENTER BLVD
SUITE 100
KATY, TX
ZIP 77494-396
Phone: (281) 693-5698
Fax: (281) 693-5690

The NPI 1669787032 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/10/2010 and was last updated on 10/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA06722	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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