Healthcare Provider Details

I. General information

NPI: 1134407802
Provider Name (Legal Business Name): TAWNY SMITH PHARM.D,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 MILLS AVE
AUSTIN TX
78731-6309
US

IV. Provider business mailing address

3501 MILLS AVE
AUSTIN TX
78731-6309
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-7000
  • Fax:
Mailing address:
  • Phone: 512-324-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number38084
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: