Individual provider Active NPI

Sandra Daniela Smith

  • Anesthesiologist Assistant
  • Houston, TX
National Provider Identifier
1124963640
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
789791039 Issued in TX
Practice address
6720 Bertner Ave
Houston, TX 77030-2604
Phone
(832) 355-2666
NPI assigned
Apr 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 789791039 TX Primary
Anesthesiologist Assistant 367H00000X 39965473 TX

Addresses

Primary practice location

6720 Bertner Ave
Houston, TX 77030-2604

Mailing address

1010 Rosine St Apt 39
Houston, TX 77019-3872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260609002159 TX Practitioner - Anesthesiology Assistant 2365913472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Baylor PLZ
2Gr900
Houston, TX 77030-3498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39965473TXMDAnesthesiologist Assistant
789791039TXMDAnesthesiologist Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1124963640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 ROSINE ST APT 39",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770193872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 BERTNER AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "832-355-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SANDRA",
        "middle_name": "DANIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "TX",
            "license": "789791039",
            "primary": true
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "TX",
            "license": "39965473",
            "primary": false
        }
    ],
    "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 May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.