MEDICARE: CYNTHIA L SMITH MD

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	208100000X	Physical Medicine & Rehabilitation Physician	K2594	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	250012463	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004DT	OTHER	TX	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861526741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA L SMITH MD

Provider Business Mailing Address
First Line	:	6247 WOODLAND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-2838
Country	:	US
Telephone Number	:	800-859-9269
Fax Number	:	337-332-6071

Provider Business Practice Location Address
First Line	:	6247 WOODLAND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-2838
Country	:	US
Telephone Number	:	800-859-9269
Fax Number	:	337-332-6071

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	10/20/2014

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Directions to “ CYNTHIA L SMITH MD” Practice Location

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