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NPI Code Detail

MEDICARE: ROBERT SMITH LPC

MEDICARE: ROBERT SMITH LPC
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
1101YP2500XProfessional Counselor12945TX

General Provider Information

NPI Number : 1043622699
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT SMITH LPC
Provider Business Mailing Address
First Line : 4001 W 15TH ST STE 465
Second Line :
City : PLANO
State : TX
Zip : 75093-5845
Country : US
Telephone Number : 972-396-4132
Fax Number :
Provider Business Practice Location Address
First Line : 4001 W 15TH ST STE 465
Second Line :
City : PLANO
State : TX
Zip : 75093-5845
Country : US
Telephone Number : 972-396-4132
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2014
Last Update Date : 05/29/2014

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