Individual
BRANDON KYLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2708 JEFFERSON DR STE A, LIBERTY, TX 77575-1036
(936) 334-8800
(936) 334-8801
Mailing address
2708 JEFFERSON DR STE A, LIBERTY, TX 77575-1036
(936) 334-8800
(936) 334-8801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA03132
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA03132
TEXAS PHYSICIAN ASSISTANT
TX
Enumeration date
05/27/2008
Last updated
02/27/2023
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