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General NPI Number Information
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NPI Number | 1629174768
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Entity Type | Organization
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Legal Business Name | DENNIS E SMITH OD PA
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 10601 RANCH ROAD 2222 STE G
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City | AUSTIN
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State | TX
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Zip | 78730-1138
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Country | US
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Telephone | 512-343-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 10601 RANCH ROAD 2222 STE G
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City | AUSTIN
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State | TX
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Zip | 78730-1138
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Country | US
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Telephone | 512-343-2020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS SMITH
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Credential | O.D.
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Telephone | 512-343-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6051T
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License Number State | TX
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