MEDICARE: ADAM W SMITH PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA15567	TX
2	363A00000X	Physician Assistant	8222	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043582489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM W SMITH PA

Provider Business Mailing Address
First Line	:	PO BOX 840003
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-0003
Country	:	US
Telephone Number	:	855-691-9890
Fax Number	:	781-276-6487

Provider Business Practice Location Address
First Line	:	300 UNIVERSITY BLVD
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-1032
Country	:	US
Telephone Number	:	512-509-0100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2012
Last Update Date	:	04/27/2026

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Directions to “ ADAM W SMITH PA” Practice Location

Language	Start Address	Practice Location

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