Individual
CHARLES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD.
Contact information
Practice address
3733 S PORT AVE, CORPUS CHRISTI, TX 78415-4532
(361) 886-6900
(361) 888-8358
Mailing address
1630 S BROWNLEE BLVD, CORPUS CHRISTI, TX 78404-3134
(361) 886-6900
(361) 888-8358
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
22499
TX
Other
Enumeration date
07/07/2006
Last updated
07/09/2007
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