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General NPI Number Information
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NPI Number | 1295500551
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Entity Type | Individual
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Provider Name | TONY SMITH LBSW
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Gender | Male
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 450 N 11TH ST
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City | BEAUMONT
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State | TX
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Zip | 77702-1804
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Country | US
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Telephone | 409-242-2539
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Fax |
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Provider Business Mailing Address
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Address Line | 5113 SHAKESPEARE RD
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City | KOUNTZE
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State | TX
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Zip | 77625-8103
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Country | US
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Telephone | 210-232-7864
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 62305
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License Number State | TX
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