Individual
DOUGLAS S SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 WONDER WORLD DR, SAN MARCOS, TX 78666-7533
(512) 396-8565
(512) 396-8567
Mailing address
PO BOX 1005, SAN MARCOS, TX 78667-1005
(512) 396-8565
(512) 396-8567
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J8777
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J8777
LICENSE
TX
05
—
P083515R9
—
TX
Enumeration date
02/02/2007
Last updated
07/08/2007
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