Provider Demographics
NPI:1992430235
Name:SMITH, SHERRELL MOTISE
Entity type:Individual
Prefix:
First Name:SHERRELL
Middle Name:MOTISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SHERRELL SMITH, EMBA
Mailing Address - Street 1:830 ROYAL GEORGE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-4468
Mailing Address - Country:US
Mailing Address - Phone:832-540-7969
Mailing Address - Fax:
Practice Address - Street 1:10023 MAIN ST STE C4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5252
Practice Address - Country:US
Practice Address - Phone:713-497-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator