Provider Demographics
NPI:1710204607
Name:SMITH, HARRY CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:CHARLES
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:H.
Other - Middle Name:CHARLES
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:25106 ARCANE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-2958
Mailing Address - Country:US
Mailing Address - Phone:832-559-7455
Mailing Address - Fax:832-559-7455
Practice Address - Street 1:1 GALLERIA BLVD
Practice Address - Street 2:SUITE 1122
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2082
Practice Address - Country:US
Practice Address - Phone:504-621-0720
Practice Address - Fax:504-621-0720
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10360R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics