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General NPI Number Information
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NPI Number | 1932325826
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Entity Type | Individual
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Provider Name | NIGEL DAVID SMITH P.T.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3505 GASTON AVE
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City | DALLAS
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State | TX
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Zip | 75246-2018
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Country | US
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Telephone | 214-820-9376
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Fax |
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Provider Business Mailing Address
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Address Line | 9815 VISTADALE DR
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City | DALLAS
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State | TX
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Zip | 75238-1529
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Country | US
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Telephone | 214-221-8608
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1087252
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License Number State | TX
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