Organization Active NPI

Kevin G. Smith PHD and Associates

  • Clinical Psychologist
  • Houston, TX
National Provider Identifier
1043402167
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KEVIN G. SMITH PHD AND ASSOCIATES
Practice address
4203 Yoakum Blvd Ste 170
Houston, TX 77006-5455
Phone
(713) 795-5151
Fax
(713) 795-5255
NPI assigned
Aug 13, 2007
Organization subpart
Yes
Parent organization
KEVIN G. SMITH PHD AND ASSOICATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kevin Gene Smith, PHDNPI 1700927167
Title
Clinical Psychologist
Phone
(713) 795-5151

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

4203 Yoakum Blvd Ste 170
Houston, TX 77006-5455

Mailing address

PO Box 541633
Houston, TX 77254-1633
Phone (713) 795-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081118000372 TX Part B Supplier - Clinic/Group Practice 8426118613 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX; Baytown, TX

National Provider Directory

National Provider Directory
Part of
Kevin G Smith PHD and Assoc

Locations

4318 Stanford St
Houston, TX 77006
Phone (713) 795-5151

4203 Yoakum Blvd
Ste 170
Houston, TX 77006
Phone (713) 795-5151

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1043402167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541633",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772541633",
            "telephone_number": "713-795-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 YOAKUM BLVD STE 170",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065455",
            "telephone_number": "713-795-5151",
            "fax_number": "713-795-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN G. SMITH PHD AND ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KEVIN G. SMITH PHD AND ASSOICATES",
        "enumeration_date": "2007-08-13",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "713-795-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.