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NPI Code Detail

MEDICARE: MICHAEL ZACHARIAH SMITH PTA

MEDICARE: MICHAEL ZACHARIAH 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 Assistant2113189TX

General Provider Information

NPI Number : 1811477581
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ZACHARIAH SMITH PTA
Provider Business Mailing Address
First Line : 1318 RYE GLEN DR
Second Line :
City : MIDLOTHIAN
State : TX
Zip : 76065-5072
Country : US
Telephone Number : 214-538-5005
Fax Number :
Provider Business Practice Location Address
First Line : 101 REESE DR
Second Line :
City : RED OAK
State : TX
Zip : 75154-2376
Country : US
Telephone Number : 214-538-5005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 08/21/2018

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Directions to “ MICHAEL ZACHARIAH SMITH PTA” Practice Location

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