Provider Demographics
NPI:1750384749
Name:SMITH, DEAN W (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:713-486-7500
Mailing Address - Fax:
Practice Address - Street 1:5420 WEST LOOP S STE 2400
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2118
Practice Address - Country:US
Practice Address - Phone:713-486-3550
Practice Address - Fax:713-383-1473
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2664207X00000X, 2086S0105X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144456402Medicaid
TX8BF245OtherBCBS
TX8B8960Medicare PIN