Individual
MRS. JENA RAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4502 MEDICAL DR FL 2, SAN ANTONIO, TX 78229-4402
(210) 358-8555
(210) 358-8576
Mailing address
4502 MEDICAL DR FL 2, SAN ANTONIO, TX 78229-4402
(210) 358-8555
(210) 358-8576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12194
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377440801
—
TX
01
—
377440802
CSHCN
TX
Enumeration date
02/12/2009
Last updated
05/08/2019
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