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Organization
PRIMARY CARE CLINIC
Active
Organization
PRIMARY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL SMITH (MD)
(646) 914-4848
Entity
Organization
Contact information
Practice address
5058 EL LAGO BND, FORT WORTH, TX 76119-5430
(646) 914-4848
Mailing address
5058 EL LAGO BND, FORT WORTH, TX 76119-5430
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/27/2026
Last updated
08/27/2026
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