MR. KENNETH MONDRE SMITH (NPI# 1669787032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669787032 |
Entity Type | Individual |
Full Name | MR. KENNETH MONDRE SMITH |
Credential | PHYSICIAN ASSISTANT |
Practice Address |
24124 Cinco Village Center Blvd Suite 100 Katy TX 77494-8396 |
Practice Telephone | 2816935698 |
Practice Fax Number | 2816935690 |
Mailing Telephone | 2816935698 |
Mailing Fax Number | 2816935690 |
Enumeration Date | 2010-08-10 |
Last Update Date | 2012-10-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA06722 | TX | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629680061 | Kenneth Lee Smith | Licensed Practical Nurse | 4905 Frontier Rd, Garland, TX 75043-3506 | 2020-08-18 |
1962067439 | Kenneth George Smith | Ophthalmology | 26 Apple Valley Road, High Rolls, NM 88325 | 2019-05-09 |
1568933141 | Kenneth Smith | Pharmacist | 4393 Fielding Ln, Norcross, GA 30092-1647 | 2018-12-08 |
1639645203 | Kenneth Smith | Social Worker | 311 S Betty Ln Apt 34, Clearwater, FL 33756-5849 | 2018-10-22 |
1487105144 | Kenneth Smith | Counselor | 4041 N High St Ste 300n, Columbus, OH 43214-3200 | 2016-10-18 |
1356898480 | Kenneth Smith | Nurse Practitioner | 6480 Se 55th St, Trenton, FL 32693-3019 | 2016-09-07 |
1942661897 | Kenneth Smith | Counselor | 26 Cahoon Rd, Apt A, Buzzards Bay, MA 02532-4802 | 2016-03-18 |
1043600893 | Kenneth Edward Smith | Counselor | 1125 48th Avenue North, Myrtle Beach, SC 29577 | 2015-02-02 |
1376945261 | Kenneth Smith II | Nurse Practitioner | 224 W D. L. Ingram Ave, Cannon Afb, NM 88103-5103 | 2014-09-23 |
1982041018 | Kenneth Lee Smith II | Psychiatry & Neurology | 2323 Sandringham Cir, Indianapolis, IN 46214-2396 | 2013-05-30 |
Street Address |
24124 CINCO VILLAGE CENTER BLVD SUITE 100 |
City | KATY |
State | TX |
Zip Code | 77494-8396 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609484344 | Toi N Morton | Behavioral Analyst | 24124 Cinco Village Center Blvd, Katy, TX 77494-8396 | 2020-07-20 |
1356891998 | Cinco Ranch Family Wellness LLC | Chiropractor | 24124 Cinco Village Center Blvd, #250, Katy, TX 77494-8396 | 2016-10-06 |
1841748480 | Megan Watier | Chiropractor | 24124 Cinco Village Center Blvd, #250, Katy, TX 77494-8396 | 2016-09-12 |
1831541317 | Glenda Marisol Montalvo | Behavioral Analyst | 24124 Cinco Village Center Blvd, Katy, TX 77494-8396 | 2016-07-07 |
1962864074 | Alton Canady | Chiropractor | 24124 Cinco Village Center Blvd, 300, Katy, TX 77494-8396 | 2016-03-28 |
1861889263 | Superior Healthcare Physical Medicine Pllc | Physical Medicine & Rehabilitation | 24124 Cinco Village Center Blvd, Suite 300, Katy, TX 77494-8396 | 2015-04-23 |
1053628016 | Joshua Waldon-robert Nevels | Chiropractor | 24124 Cinco Village Center Blvd, Suite 300, Katy, TX 77494-8396 | 2010-09-10 |
1457668659 | Lone Star Family Chiropractic | Chiropractor | 24124 Cinco Village Center Blvd, Suite 300, Katy, TX 77494-8396 | 2010-09-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649880899 | Julie Dyan Meyers | Speech-Language Pathologist | 4747 Fm 1463 Suite 900, Katy, TX 77494 | 2020-08-03 |
1235763426 | Lucy J Pena | Technician | 28106 Sugarside Glen Dr, Katy, TX 77494 | 2020-02-26 |
1063042455 | Wonace LLC | Durable Medical Equipment & Medical Supplies | 2717 Commercial Blvd, E200, Katy, TX 77494 | 2020-01-24 |
1801431002 | Justin Lee Landers | Specialist/Technologist | 2818 Fair Chase, Katy, TX 77494 | 2019-11-12 |
1285276006 | Chrysalis Group LLC | Pharmacy | 1259 Fm 1463 Suite 700, Katy, TX 77494 | 2019-10-14 |
1033760400 | Aaron Moniotte | Pharmacist | 23331 Grand Reserve Dr, Katy, TX 77494 | 2019-09-26 |
1467001743 | Julie Hankinson | Technician | 4903 Surrey Park Circle, Katy, TX 77494 | 2019-09-09 |
1710532148 | Icome2u Nursing Providers Inc | Nurse Practitioner | 26307 Sundown Cove Lane, Katy, TX 77494 | 2019-08-02 |
1881252203 | Encompass Health Rehabilitation Hospital of Katy, LLC | Rehabilitation Hospital | 23331 Grand Reserve Drive, Katy, TX 77494 | 2019-05-31 |
1407312945 | Cvs Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 322 Cane Island Pkwy, Katy, TX 77494 | 2019-02-20 |
Find all providers in zip 77494 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497297394 | Chelsea Lynn Halbleib | Physician Assistant | 1331 W Grand Pkwy N Ste 350, Katy, TX 77493-2711 | 2016-11-08 |
1992161996 | Cindy Lin | Physician Assistant | 1331 W Grand Pkwy N Ste 130, Katy, TX 77493 | 2016-01-06 |
1417201948 | Elizabeth Buza Devlin | Physician Assistant | 21312 Provincial Blvd., Katy, TX 77450 | 2012-11-06 |
1669002648 | Ming Zhu | Physician Assistant | 750 Westgreen Blvd, Katy, TX 77450-2799 | 2020-01-18 |
1184267056 | Isaach Majid | Physician Assistant | 10705 Spring Green Blvd Ste 600, Katy, TX 77494-4154 | 2019-10-23 |
1396273595 | Radha Jayakumar Bernander | Physician Assistant | 21308 Provincial Blvd, Katy, TX 77450-7580 | 2017-06-01 |
1376094193 | Demori Driver | Physician Assistant | 19333 Clay Rd, Katy, TX 77449-4001 | 2016-10-17 |
1225493281 | Insiya Valika | Physician Assistant | 19121 W Little York Rd, Ste B, Katy, TX 77449 | 2015-12-17 |
1205259561 | Michelle Ann Osborne-spencer | Physician Assistant | 701 S Fry Rd, Suite 103, Katy, TX 77450-2255 | 2014-01-22 |
1538432505 | Amber Lee Littler | Physician Assistant | 20214 Braidwood Dr, Suite 215, Katy, TX 77450-2138 | 2012-02-21 |
Find all providers in KATY |
Please comment or provide details below to improve the information on MR. KENNETH MONDRE SMITH.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.