Healthcare Provider Details

I. General information

NPI: 1598250128
Provider Name (Legal Business Name): STUART LLOYD SMITH NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 ONEAL ST
GAINESVILLE TX
76240
US

IV. Provider business mailing address

1001 W EAGLE DR
DECATUR TX
76234-3745
US

V. Phone/Fax

Practice location:
  • Phone: 940-580-3070
  • Fax: 940-580-2042
Mailing address:
  • Phone: 940-627-8982
  • Fax: 940-627-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number832334
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: