MEDICARE: WILLIAM CARL SMITH M.D.

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	207Y00000X	Otolaryngology Physician	G8427	TX

General Provider Information

NPI Number	:	1336140680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM CARL SMITH M.D.

Provider Business Mailing Address
First Line	:	8715 VILLAGE DR
Second Line	:	STE 618
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-5407
Country	:	US
Telephone Number	:	210-967-7377
Fax Number	:	210-967-6502

Provider Business Practice Location Address
First Line	:	8715 VILLAGE DR
Second Line	:	STE 618
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-5407
Country	:	US
Telephone Number	:	210-967-7377
Fax Number	:	210-967-6502

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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