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General NPI Number Information
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NPI Number | 1164079752
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Entity Type | Individual
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Provider Name | DEREK SMITH RPH
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Gender | Male
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | ONE MEDICAL PLAZA
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City | PAMPA
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State | TX
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Zip | 79065
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Country | US
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Telephone | 806-663-5601
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Fax |
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Provider Business Mailing Address
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Address Line | ONE MEDICAL PLAZA
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City | PAMPA
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State | TX
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Zip | 79065
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Country | US
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Telephone | 806-663-5601
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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 | 208U00000X
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Taxonomy Name | Clinical Pharmacology Physician
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License Number | 38160
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License Number State | TX
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