Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | AT6947 | TX |
Y | 213ES0000X | Sports Medicine | AT6947 | TX |
NPI | 1538687108 |
---|---|
Provider Name | Jocelyn J Smith |
First Address | Austin, TX 78758-3720 |
Second Address | Austin, TX 78758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2017 |
Last Update Date | 05/09/2017 |