Provider Demographics
NPI:1427249457
Name:SMITH, FELECIA E (FNP)
Entity type:Individual
Prefix:MS
First Name:FELECIA
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8930 FOURWINDS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1971
Mailing Address - Country:US
Mailing Address - Phone:210-902-9596
Mailing Address - Fax:210-693-1491
Practice Address - Street 1:8930 FOURWINDS DR STE 100
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1971
Practice Address - Country:US
Practice Address - Phone:210-590-5956
Practice Address - Fax:210-693-1491
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652895363LF0000X
TXAP116133363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01165933OtherRAILROAD MEDICARE
TX272605YNVLOtherMEDICARE PTAN
TX272605YNVLOtherMEDICARE PTAN
TXP01165933OtherRAILROAD MEDICARE
TX00115XOtherMEDICARE GROUP
TX272605YNVLOtherIND PTAN