Healthcare Provider Details

I. General information

NPI: 1093210429
Provider Name (Legal Business Name): KAITLYN SMITH WERNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLARKSVILLE ST STE 195
PARIS TX
75460-6087
US

IV. Provider business mailing address

695 33RD ST SE
PARIS TX
75460-6561
US

V. Phone/Fax

Practice location:
  • Phone: 903-785-8480
  • Fax:
Mailing address:
  • Phone: 580-298-7703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License NumberT2289
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberT2289
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: