Individual
DR. EILEEN A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD PA
Contact information
Practice address
8601 VILLAGE DRIVE, #118, SAN ANTONIO, TX 78217
(210) 967-0515
(210) 655-9697
Mailing address
PO BOX 34567, SAN ANTONIO, TX 78265
(210) 967-0515
(210) 655-9697
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
TXJ1141
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099920302
—
TX
05
—
099920303
—
TX
01
—
8R7170
BCBS
TX
01
—
P00079579
MEDICARE RAILROAD (PTAN)
TX
Enumeration date
08/18/2006
Last updated
01/07/2009
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