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NPI 1396812012

NPI 1396812012 : SMARTCARE OF TEXAS : GEORGETOWN, TX

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General NPI Number Information
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    NPI Number           |    1396812012
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    Entity Type          |    Organization 
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    Legal Business Name  |    SMARTCARE OF TEXAS 
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Dates
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    Enumeration Date     |    11/29/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    3613 WILLIAMS DR STE 701 
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    City                 |    GEORGETOWN
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    State                |    TX
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    Zip                  |    78628-1373
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    Country              |    US
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    Telephone            |    512-869-3200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3613 WILLIAMS DR STE 701 
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    City                 |    GEORGETOWN
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    State                |    TX
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    Zip                  |    78628-1373
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    Country              |    US
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    Telephone            |    512-869-3200
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CHIEF EXECUTIVE OFFICER
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    Name                 |    MRS. NANCY  PHILPOTT 
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    Credential           |    
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    Telephone            |    512-869-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    
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    License Number State |    
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