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NPI Code Detail

MEDICARE: SMITHSON VALLEY FAMILY MEDICINE, LLP

MEDICARE: SMITHSON VALLEY FAMILY MEDICINE, LLP
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
1207Q00000XFamily Medicine PhysicianK5049TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841322013
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMITHSON VALLEY FAMILY MEDICINE, LLP
Provider Business Mailing Address
First Line : 6098 FM 311
Second Line : SMITHSON VALLEY FAMILY MEDICINE
City : SPRING BRANCH
State : TX
Zip : 78070-7253
Country : US
Telephone Number : 830-885-5541
Fax Number : 830-885-5542
Provider Business Practice Location Address
First Line : 6098 FM 311
Second Line : SMITHSON VALLEY FAMILY MEDICINE
City : SPRING BRANCH
State : TX
Zip : 78070-7253
Country : US
Telephone Number : 830-885-5541
Fax Number : 830-885-5542
Authorized Official
Title or Position : OWNER
Name : MATTHEW W NICOLA
Credential : MD
Telephone Number : 830-885-5541
Provider Enumeration Date : 03/12/2007
Last Update Date : 05/29/2008

Similar Medicare Providers

1124096581 — DR. MATTHEW W NICOLA MD
Practice Location Address:
6098 FM 311
SPRING BRANCH, TX
78070-7253
Practice Phone: 830-885-5541
Practice Fax: 830-885-5542
1992993182 — ANDREA MARIE MORRIS PA-C
Practice Location Address:
6098 FM 311
SPRING BRANCH, TX
78070-7253
Practice Phone: 830-885-5541
Practice Fax: 830-885-5542
1528361995 — MS. HEATHER RENEE OLSON PA
Practice Location Address:
6098 FM 311
SPRING BRANCH, TX
78070-7253
Practice Phone: 830-885-5541
Practice Fax: 830-885-5542
1740809706 — KRISTIN HANCOCK PA-C, RD, LD
Practice Location Address:
6098 FM 311
SPRING BRANCH, TX
78070-7253
Practice Phone: 830-885-5541
Practice Fax:
1679235410 — STEPHANY SHENEMAN
Practice Location Address:
6098 FM 311
SPRING BRANCH, TX
78070-7253
Practice Phone: 830-885-5541
Practice Fax:
1790805794 — FRANKLIN GAIL BURTON II R.PH.
Practice Location Address:
7253 GOODMAN RD
OLIVE BRANCH, MS
38654-1906
Practice Phone: 662-895-8383
Practice Fax: 662-895-9088

Directions to “SMITHSON VALLEY FAMILY MEDICINE, LLP ” Practice Location

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