| Doctor Name: | DR. JERRY DON SMITH |
| NPI Number: | 1265781645 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 36009 |
| Business Practice Address: | 208 S Twin City Hwy Ste B Nederland, TX - 776274201 |
| Business Phone Number: | 4093443588 |
| Business Fax Number: | 9726927303 |
| Mailing Address: | 2507 8th St., PORT NECHES |
| State: | TX |
| Postal Code: | 77651 |
| Phone Number: | 4093443581 |
| Fax Number: | 9726927303 |
| NPI Enumeration Date: | 08/31/2012 |
| NPI Last Update Date: | 04/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 36009 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |