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General NPI Number Information
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NPI Number | 1356663405
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Entity Type | Organization
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Legal Business Name | GREGORY W. SMITH, MD PA
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 1090 E ALTON GLOOR BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78526-3822
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Country | US
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Telephone | 956-542-1850
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Fax | 956-542-2879
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Provider Business Mailing Address
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Address Line | PO BOX 1984
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City | AMARILLO
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State | TX
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Zip | 79105-1984
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Country | US
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Telephone | 956-542-1850
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Fax | 956-542-2879
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY W SMITH
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Credential | MD
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Telephone | 956-542-1850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K5700
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License Number State | TX
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