MEDICARE: NATALIE MARIE SMITH M.D.

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	207R00000X	Internal Medicine Physician	P7571	TX

General Provider Information

NPI Number	:	1831489590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE MARIE SMITH M.D.

Provider Business Mailing Address
First Line	:	3417 GASTON AVE STE 1100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2037
Country	:	US
Telephone Number	:	469-800-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3417 GASTON AVE STE 1100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2037
Country	:	US
Telephone Number	:	469-800-9000
Fax Number	:

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

Provider Enumeration Date	:	04/14/2011
Last Update Date	:	04/12/2022

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