Provider Demographics
NPI:1306138235
Name:SMITH, STACY VICTORIA (MD)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:VICTORIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1360 POST OAK BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3312
Mailing Address - Country:US
Mailing Address - Phone:713-524-3434
Mailing Address - Fax:713-524-3220
Practice Address - Street 1:4460 BISSONNET ST STE 200
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3234
Practice Address - Country:US
Practice Address - Phone:713-524-3434
Practice Address - Fax:713-524-3220
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2025-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ39722084N0400X, 207WX0109X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX358404703Medicaid
TX358404704Medicaid