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NPI Code Detail

MEDICARE: GREGORY HEATH SMITH DO

MEDICARE: GREGORY HEATH SMITH DO
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
1207T00000XNeurological Surgery PhysicianJ3905TX

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 : 1871533752
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY HEATH SMITH DO
Provider Business Mailing Address
First Line : 800 5TH AVE STE 500
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-7304
Country : US
Telephone Number : 817-250-4280
Fax Number :
Provider Business Practice Location Address
First Line : 800 5TH AVE STE 500
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-7304
Country : US
Telephone Number : 817-250-4280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 02/21/2022

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Directions to “ GREGORY HEATH SMITH DO” Practice Location

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