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Individual
KELLY ANN SMITH
Active
Individual
KELLY ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
PA00311
TX
363A00000X
Physician Assistant
1016844
TX
Other
Enumeration date
11/30/2005
Last updated
11/12/2019
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