Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | N3317 | TX |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | N3317 | TX |
N | 207RG0300X | Geriatric Medicine | N3317 | TX |
NPI | 1487848479 |
---|---|
Provider Name | Paul Alan Smith |
First Address | Dallas, TX 75284-8491 |
Second Address | Waco, TX 76712-8897 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2007 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03353844 | (05) | NY |