Provider Demographics
NPI:1629561477
Name:SMITH, CHRISTINA YVETTE (PNP-PC)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:YVETTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:122 W JOHN CARPENTER FWY STE 420
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2014
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:972-329-0042
Practice Address - Street 1:294 UPTOWN BLVD STE 120
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3537
Practice Address - Country:US
Practice Address - Phone:972-293-6300
Practice Address - Fax:972-293-6301
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137286363LP0200X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics