Healthcare Provider Details

I. General information

NPI: 1386470201
Provider Name (Legal Business Name): MORGAN SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14651 DALLAS PKWY STE 200
DALLAS TX
75254-8856
US

IV. Provider business mailing address

709 SNAPDRAGON LN
DESOTO TX
75115-6689
US

V. Phone/Fax

Practice location:
  • Phone: 214-575-2999
  • Fax:
Mailing address:
  • Phone: 972-697-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number124976
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: