MEDICARE: DR. ELINA SMILEY

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	247ZC0005X	Clinical Laboratory Director (Non-physician)

General Provider Information

NPI Number	:	1861243255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELINA SMILEY

Provider Business Mailing Address
First Line	:	1217 BLUE LAKE BLVD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76005-4527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 BLUE LAKE BLVD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76005-4527
Country	:	US
Telephone Number	:	217-751-2625
Fax Number	:

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

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	04/01/2024

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Directions to “ DR. ELINA SMILEY ” Practice Location

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