Doctor Name: | GARRETT O SMITH |
NPI Number: | 1386677243 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | PA07982 |
Business Practice Address: | 2418 W. Main St Gun Barrel City, TX - 75156 |
Business Phone Number: | 9037132000 |
Business Fax Number: | 9037132004 |
Mailing Address: | 2418 W Main St, GUN BARREL CITY |
State: | TX |
Postal Code: | 751563638 |
Phone Number: | 9037132000 |
Fax Number: | 9037132004 |
NPI Enumeration Date: | 07/07/2006 |
NPI Last Update Date: | 10/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA07982 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |