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General NPI Number Information
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NPI Number | 1114137064
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Entity Type | Individual
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Provider Name | JASON LANDON SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 1308 WONDER WORLD DR
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City | SAN MARCOS
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State | TX
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Zip | 78666-7532
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Country | US
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Telephone | 512-396-5199
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Fax | 512-454-4575
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | M6888
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License Number State | TX
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