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General NPI Number Information
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NPI Number | 1689853368
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Entity Type | Individual
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Provider Name | LANDON ENSIGN SMITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 555 CREEKSIDE XING
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-2594
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Country | US
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Telephone | 830-387-5270
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Fax | 830-387-5329
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Provider Business Mailing Address
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Address Line | 8711 VILLAGE DR SUITE 114
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5418
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Country | US
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Telephone | 830-387-5270
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Fax | 830-387-5329
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N4760
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License Number State | TX
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