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1255224283 NPI number — CARSON KEITH SMITH MD

NPI Number: 1255224283
Health Care Provider/Practitioner: CARSON KEITH SMITH MD

Information about “1255224283” NPI (CARSON KEITH SMITH MD) exists in 1255224283 in HTML format HTML  |  1255224283 in plain Text format TXT  |  1255224283 in PDF (Portable Document Format) PDF  |  1255224283 in an XML format XML  formats.

NPI Number : 1255224283 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255224283",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SMITH",
    "FirstName": "CARSON",
    "MiddleName": "KEITH",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "301 UNIVERSITY BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GALVESTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77555-1173",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "409-266-7856",
    "MailingAddressFaxNumber": "409-772-1224",
    "FirstLinePracticeLocationAddress": "301 UNIVERSITY BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GALVESTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77555-1173",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "409-266-7856",
    "PracticeLocationAddressFaxNumber": "409-772-1224",
    "EnumerationDate": "05/29/2025",
    "LastUpdateDate": "06/16/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207L00000X",
        "TaxonomyName": "Anesthesiology Physician",
        "LicenseNumber": "BP10094027",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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