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NPI Code Detail

MEDICARE: ERIC KINDLE SMITH PTA

MEDICARE: ERIC KINDLE SMITH PTA
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
1225200000XPhysical Therapy Assistant2155646TX

General Provider Information

NPI Number : 1770168452
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC KINDLE SMITH PTA
Provider Business Mailing Address
First Line : 5920 SAINTSBURY DR APT 229
Second Line :
City : THE COLONY
State : TX
Zip : 75056-5278
Country : US
Telephone Number : 806-676-7994
Fax Number :
Provider Business Practice Location Address
First Line : 3208 THUNDERBIRD LN
Second Line :
City : PLANO
State : TX
Zip : 75075-2321
Country : US
Telephone Number : 972-422-2214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2021
Last Update Date : 03/14/2021

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