MEDICARE: DR. STEPHEN LEE SMITH DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	692019	TX
2	213E00000X	Podiatrist	692019	TX
3	213ES0000X	Sports Medicine Podiatrist	692019	TX
4	213ES0131X	Foot Surgery Podiatrist	692019	TX

General Provider Information

NPI Number	:	1346807583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN LEE SMITH DPM

Provider Business Mailing Address
First Line	:	3007 DAWN DR STE 101
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-2864
Country	:	US
Telephone Number	:	512-819-4555
Fax Number	:	512-819-4559

Provider Business Practice Location Address
First Line	:	3007 DAWN DR STE 101
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-2864
Country	:	US
Telephone Number	:	512-819-4555
Fax Number	:

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

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	03/04/2026

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Directions to “ DR. STEPHEN LEE SMITH DPM” Practice Location

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