MEDICARE: THOMAS E. SMITH, MD, 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	207Q00000X	Family Medicine Physician

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	:	1508032152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS E. SMITH, MD, PA

Provider Business Mailing Address
First Line	:	PO BOX 32002
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79120-2002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 CANYON CREEK DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79118-3830
Country	:	US
Telephone Number	:	806-382-8686
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS EDWIN SMITH
Credential	:	MD
Telephone Number	:	806-382-8686

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	02/24/2009

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