Individual
DR. BRYAN E SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
5411 PLAZA DR, SUITE E, TEXARKANA, TX 75503-1666
(903) 255-0171
(903) 255-0172
Mailing address
5411 PLAZA DR, SUITE E, TEXARKANA, TX 75503-1666
(903) 255-0171
(903) 255-0172
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2-5159
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307068-01
—
TX
05
—
139710719
—
AR
Enumeration date
10/07/2005
Last updated
08/25/2011
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