Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G5625 | TX |
NPI | 1245232172 |
---|---|
Provider Name | Dr. James Len Smith JR. |
First Address | Austin, TX 78759-4107 |
Second Address | Austin, TX 78759-4107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 08/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122429704 | (05) | TX |
200023135 | MEDICARE RAILROAD (01) | |
E76912 | (02) |