Individual
CLYDE D. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 MALLARD LN, TAYLOR, TX 76574-1208
(512) 914-2628
(254) 200-4099
Mailing address
PO BOX 938, KILLEEN, TX 76540-0938
(254) 634-6999
(254) 200-4099
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E3457
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137633715
—
TX
Enumeration date
09/27/2006
Last updated
02/28/2011
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