Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | 32140 | OK |
Y | 2080P0204X | Pediatric Emergency Doctor | R1882 | TX |
NPI | 1023456431 |
---|---|
Provider Name | Natalie Nimer Smith |
First Address | Lubbock, TX 79410-1105 |
Second Address | Lubbock, TX 79410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 05/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023456431 | FIRSTCARE (01) | TX |
17221285 | (05) | NM |
371236601 | (05) | TX |
574631YKT8 | MEDICARE (01) | TX |
8GU878 | BCBS (01) | TX |