| Doctor Name: | DR. LIESL BREDESON SMITH |
| NPI Number: | 1093767741 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | K3012 |
| Business Practice Address: | 8160 Walnut Hill Ln Suite 224 Dallas, TX - 752314339 |
| Business Phone Number: | 2143651150 |
| Business Fax Number: | 2143632477 |
| Mailing Address: | 1701 N Collins Blvd, 327 RICHARDSON |
| State: | TX |
| Postal Code: | 750803564 |
| Phone Number: | 9726442819 |
| Fax Number: | 9726802949 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 12/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | K3012 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |