Healthcare Provider Details

I. General information

NPI: 1629012000
Provider Name (Legal Business Name): BOBBY W SMITH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 PERRYTON PKWY
PAMPA TX
79065-2821
US

IV. Provider business mailing address

3023 PERRYTON PKWY
PAMPA TX
79065-2821
US

V. Phone/Fax

Practice location:
  • Phone: 806-665-0801
  • Fax: 806-665-8503
Mailing address:
  • Phone: 806-665-0801
  • Fax: 806-665-8503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM4552
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: