Individual
DR. BENJAMIN L. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
910 E WHITESTONE BLVD, CEDAR PARK, TX 78613-9093
(512) 260-6100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K5698
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080161622
RR/MEDICARE
TX
01
—
1005480-01
CSHCN
TX
05
—
1005480-02
—
TX
01
—
87430Y
BLUE SHIELD
TX
Enumeration date
04/03/2006
Last updated
10/28/2020
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