MEDICARE: MICHELE LEANNE GARANT-SMOTHERMAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	L9695	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1Z4295	OTHER	TX	TAMU PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154328862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE LEANNE GARANT-SMOTHERMAN DO

Provider Business Mailing Address
First Line	:	8441 STATE HWY 47
Second Line	:	STE 3115
City	:	BRYAN
State	:	TX
Zip	:	77807-8306
Country	:	US
Telephone Number	:	979-436-9703
Fax Number	:	979-693-7442

Provider Business Practice Location Address
First Line	:	1602 ROCK PRAIRIE RD STE 3400
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-5992
Country	:	US
Telephone Number	:	979-693-0737
Fax Number	:	979-693-7442

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	11/18/2025

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