NPIMap

Organization Active NPI

Utmb

  • Prison Health Clinic/Center
  • Stafford, TX
National Provider Identifier
1063821981
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
License
233196 Issued in TX
Legal business name
UTMB
Practice address
12603 Southwest Fwy Ste 335
Stafford, TX 77477-3842
Phone
(281) 269-6700
Fax
(281) 265-5163
NPI assigned
Aug 5, 2014
Last updated
Aug 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Authorized official

Name
Ms. Sandra K Smock, APN
Title
Provider
Phone
(281) 269-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X 233196 TX Primary

Addresses

Primary practice location

12603 Southwest Fwy Ste 335
Stafford, TX 77477-3842

Mailing address

12603 Southwest Fwy Ste 335
Stafford, TX 77477-3842
Phone (281) 269-6700

National Provider Directory

National Provider Directory
Tax ID family
University of Texas Medical Branch at Galveston19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

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": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1063821981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12603 SOUTHWEST FWY STE 335",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773842",
            "telephone_number": "281-269-6700",
            "fax_number": "281-265-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12603 SOUTHWEST FWY STE 335",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773842",
            "telephone_number": "281-269-6700",
            "fax_number": "281-265-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "SMOCK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "281-269-6700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "TX",
            "license": "233196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.