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Individual
NATHAN E SMITH
Active
Individual
NATHAN E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02984
TX
363AM0700X
Medical Physician Assistant
PA02984
TX
363AS0400X
Surgical Physician Assistant
PA02984
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104828185
—
TX
Enumeration date
08/10/2005
Last updated
10/21/2013
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