Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 12270 | TX |
NPI | 1447590732 |
---|---|
Provider Name | Newell Smith Estess III |
First Address | Carrollton, TX 75006-2049 |
Second Address | Carrollton, TX 75006-2049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2013 |
Last Update Date | 22/02/2013 |