Individual
SAMUEL DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
904 FORD ST, LLANO, TX 78643-2345
(830) 953-1700
(830) 953-1717
Mailing address
904 FORD ST, LLANO, TX 78643-2345
(830) 953-1700
(830) 953-1717
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
TX
363AM0700X
Medical Physician Assistant
Primary
—
TX
Other
Enumeration date
09/15/2022
Last updated
09/11/2024
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