Organization
JUDSON P SMITH MD PA
Active
Other names
MAIN VIEW OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA M FITZGERALD (OFFICE MANAGER)
(817) 338-4081
Entity
Organization
Contact information
Practice address
417 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 338-0875
(817) 870-1612
Mailing address
417 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 338-0875
(817) 870-1612
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D9667
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149393401
—
TX
Enumeration date
04/25/2007
Last updated
11/04/2010
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