Healthcare Provider Details

I. General information

NPI: 1104814607
Provider Name (Legal Business Name): FILIZ A SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 MONTANO RD NW STE A1
ALBUQUERQUE NM
87107-5200
US

IV. Provider business mailing address

PO BOX 29329
SANTA FE NM
87592-9329
US

V. Phone/Fax

Practice location:
  • Phone: 505-777-3003
  • Fax:
Mailing address:
  • Phone: 505-316-3157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number57446
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9112874-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2018-0182
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: