MEDICARE: DR. ROBERT EUGENE SMITH II MD

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	207W00000X	Ophthalmology Physician	45628	GA
2	207W00000X	Ophthalmology Physician	M3742	TX

General Provider Information

NPI Number	:	1427036706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT EUGENE SMITH II MD

Provider Business Mailing Address
First Line	:	1228 QUEEN PEGGY LN
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-5809
Country	:	US
Telephone Number	:	972-899-2260
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 DALLAS PKWY
Second Line	:	SUITE 206
City	:	PLANO
State	:	TX
Zip	:	75093-4361
Country	:	US
Telephone Number	:	972-378-3937
Fax Number	:

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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