Provider Demographics
NPI:1255832887
Name:SMITH, SOYA ANNA (RN)
Entity type:Individual
Prefix:
First Name:SOYA
Middle Name:ANNA
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SOYA
Other - Middle Name:ANNA
Other - Last Name:JOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2495 S MASON RD APT 236
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6074
Mailing Address - Country:US
Mailing Address - Phone:346-387-2274
Mailing Address - Fax:
Practice Address - Street 1:2495 S MASON RD APT 236
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6074
Practice Address - Country:US
Practice Address - Phone:346-387-2274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX926662163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse