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NPI Code Detail

MEDICARE: WADE S SMITH PA

MEDICARE: WADE S 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
1363AS0400XSurgical Physician AssistantPA04134TX
2363A00000XPhysician Assistant163816MT

General Provider Information

NPI Number : 1386678456
Entity Type Code : Individual
Provider Name (Legal Business Name) : WADE S SMITH PA
Provider Business Mailing Address
First Line : 6301 HARRIS PKWY STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4266
Country : US
Telephone Number : 817-877-3432
Fax Number :
Provider Business Practice Location Address
First Line : 6301 HARRIS PKWY STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4266
Country : US
Telephone Number : 817-877-3432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 05/26/2026

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Directions to “ WADE S SMITH PA” Practice Location

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