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General NPI Number Information
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NPI Number | 1073175410
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Entity Type | Individual
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Provider Name | REAGAN AUSTIN CARL SMITH DDS
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Gender | Male
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Dates
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Enumeration Date | 07/06/2019
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 2525 LOUETTA RD STE 100
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City | SPRING
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State | TX
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Zip | 77388-4785
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Country | US
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Telephone | 281-350-8852
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Fax |
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Provider Business Mailing Address
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Address Line | 19702 BELLA LOMA APT 8002
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City | SAN ANTONIO
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State | TX
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Zip | 78256-0008
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Country | US
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Telephone | 512-289-5597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35292
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 35292
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License Number State | TX
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