MEDICARE: SHALYNN SMITH DSCPT

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	225100000X	Physical Therapist	1123081	TX

General Provider Information

NPI Number	:	1952728578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHALYNN SMITH DSCPT

Provider Business Mailing Address
First Line	:	1900 PURSLEY RD
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-4734
Country	:	US
Telephone Number	:	512-923-3248
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 PURSLEY RD
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-4734
Country	:	US
Telephone Number	:	512-923-3248
Fax Number	:

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

Provider Enumeration Date	:	03/20/2014
Last Update Date	:	03/20/2014

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