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General NPI Number Information
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NPI Number | 1548555865
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Entity Type | Individual
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Provider Name | ERIC T SMITH ATP
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Gender | Male
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 1220 PARKWAY DR
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City | SANTA FE
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State | NM
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Zip | 87507-7257
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Country | US
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Telephone | 505-424-8840
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Fax | 505-345-6511
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Provider Business Mailing Address
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Address Line | 9494 KIRBY DR
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City | HOUSTON
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State | TX
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Zip | 77054-2521
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Country | US
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Telephone | 713-791-9080
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Fax | 713-791-9084
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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