Organization
HERITAGE NETWORK PHYSICIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD W SMITH D.O. (PRESIDENT)
(682) 626-5488
Entity
Organization
Contact information
Practice address
800 MOUNTAIN TER, HURST, TX 76053-4210
(682) 626-5488
(817) 665-2974
Mailing address
800 MOUNTAIN TER, HURST, TX 76053-4210
(682) 626-5488
(817) 665-2974
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E1757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881511
—
TX
Enumeration date
07/27/2009
Last updated
09/18/2014
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