Individual
DR. MATTHEW THOMAS SMETANICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 JOHN HOOVER PKWY, BLDG 4, SUITE B, BURNET, TX 78611
(512) 930-3909
(512) 869-5868
Mailing address
4513 WILLIAMS DR, GEORGETOWN, TX 78633-1302
(512) 930-3909
(512) 869-5868
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
N4111
TX
207N00000X
Dermatology Physician
OS014480
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N4111
TX MEDICAL LICENSE
TX
Enumeration date
01/23/2008
Last updated
05/28/2019
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