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Individual
ERIC WAYNE SMITH
Active
Individual
ERIC WAYNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP144510
TX
363LP2300X
Primary Care Nurse Practitioner
AP144510
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Q4045
PTAN
TX
Enumeration date
09/01/2020
Last updated
11/11/2021
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