Individual
DR. STEPHEN REILLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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