Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 7306TG | TX |
NPI | 1013165547 |
---|---|
Provider Name | Ms. Kathryn Elizabeth Smith |
First Address | San Antonio, TX 78256-9603 |
Second Address | San Antonio, TX 78256-9603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2008 |
Last Update Date | 12/08/2010 |