Individual
DR. STEPHEN REILLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7200 N MOPAC EXPY, SUITE 200, AUSTIN, TX 78731-3069
(512) 241-1806
(512) 623-7892
Mailing address
7200 N MOPAC EXPY, SUITE 200, AUSTIN, TX 78731-3069
(512) 241-1806
(512) 623-7892
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M4952
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184558802
—
TX
05
—
66385865
—
NM
01
—
P01010506
RR MEDICARE
—
Enumeration date
10/27/2005
Last updated
04/12/2012
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