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NPI Code Detail

MEDICARE: CHERA M SMITH PA-C

MEDICARE:   CHERA M SMITH  PA-C
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
1363AM0700XMedical Physician AssistantPA11379TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649708637
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERA M SMITH PA-C
Provider Business Mailing Address
First Line : 5450 CLEARFORK MAIN ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-3514
Country : US
Telephone Number : 817-334-1400
Fax Number : 817-334-1410
Provider Business Practice Location Address
First Line : 5450 CLEARFORK MAIN ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-3514
Country : US
Telephone Number : 817-334-1400
Fax Number : 817-334-1410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2017
Last Update Date : 07/21/2022

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Directions to “ CHERA M SMITH PA-C” Practice Location

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