Organization
DR RONALD N SMITH OPTOMETRIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD N SMITH OD (PRESIDENT)
(903) 597-9020
Entity
Organization
Contact information
Practice address
2732 S BROADWAY AVE, TYLER, TX 75701-5412
(903) 597-9020
Mailing address
2732 S BROADWAY AVE, TYLER, TX 75701-5412
(903) 597-9020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00014S
MEDICARE PTAN
TX
01
—
0025EX
GROUP NUMBER FOR BLUECROS
TX
Enumeration date
03/02/2007
Last updated
05/20/2013
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