MEDICARE: RICKY C SMITH

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	183500000X	Pharmacist	18905	TX

General Provider Information

NPI Number	:	1518265016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICKY C SMITH

Provider Business Mailing Address
First Line	:	3601 W WILLIAM CANNON DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1533
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 W WILLIAM CANNON DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1533
Country	:	US
Telephone Number	:	512-892-0930
Fax Number	:

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

Provider Enumeration Date	:	03/08/2011
Last Update Date	:	03/29/2026

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Directions to “ RICKY C SMITH ” Practice Location

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