Individual
TAMIKO SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
410 NW 11TH ST # 112, GRAND PRAIRIE, TX 75050-5416
(469) 212-7879
(469) 480-4763
Mailing address
410 NW 11TH ST # 112, GRAND PRAIRIE, TX 75050-5416
(469) 212-7879
(469) 480-4763
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
45D2163869
TX
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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