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NPI Code Detail

MEDICARE: BANE L SMITH MD

MEDICARE:   BANE L SMITH  MD
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
1207Q00000XFamily Medicine PhysicianH2968TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790703098
Entity Type Code : Individual
Provider Name (Legal Business Name) : BANE L SMITH MD
Provider Business Mailing Address
First Line : 3920 W WHEATLAND RD STE 152
Second Line :
City : DALLAS
State : TX
Zip : 75237-3404
Country : US
Telephone Number : 214-467-0432
Fax Number : 214-467-0635
Provider Business Practice Location Address
First Line : 3920 W WHEATLAND RD STE 152
Second Line :
City : DALLAS
State : TX
Zip : 75237-3404
Country : US
Telephone Number : 214-467-0432
Fax Number : 214-467-0635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 09/27/2021

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Directions to “ BANE L SMITH MD” Practice Location

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