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General NPI Number Information
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NPI Number | 1619266772
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Entity Type | Individual
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Provider Name | BENJAMIN CARL SMITH
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Gender | Male
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 12201 MERIT DR STE 450
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City | DALLAS
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State | TX
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Zip | 75251-3127
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Country | US
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Telephone | 972-532-3024
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Fax | 972-532-3189
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Provider Business Mailing Address
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Address Line | 12201 MERIT DR STE 450
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City | DALLAS
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State | TX
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Zip | 75251-3127
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Country | US
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Telephone | 972-532-3024
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Fax | 972-532-3189
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | P7987
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License Number State | TX
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