Organization
WISE OBSTETRICS & GYNECOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE C SMITH MD (PRESIDENT)
(940) 626-8008
Entity
Organization
Contact information
Practice address
2451 S FM 51, SUITE 300, DECATUR, TX 76234-3858
(940) 626-8008
(940) 627-4709
Mailing address
2451 S FM 51, SUITE 300, DECATUR, TX 76234-3858
(940) 626-8008
(940) 627-4709
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010KP
BCBS
TX
05
—
162805901
—
TX
Enumeration date
04/24/2006
Last updated
06/06/2016
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