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General NPI Number Information
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NPI Number | 1245204890
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Entity Type | Individual
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Provider Name | GREGORY A. SMITH FNP
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 2955 HARRISON ST SUITE 301
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City | BEAUMONT
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State | TX
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Zip | 77702-1154
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Country | US
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Telephone | 409-923-1650
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Fax | 409-923-1651
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Provider Business Mailing Address
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Address Line | 2955 HARRISON ST SUITE 301
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City | BEAUMONT
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State | TX
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Zip | 77702-1154
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Country | US
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Telephone | 409-923-1650
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Fax | 409-923-1651
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 559394
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License Number State | TX
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