Individual
DR. WYATT ALEXANDER RIVAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZSO ORTHOPAED, 3551 ROGER BROOKE DR, JBSA-FORT SAM HOUSTON, TX 78234-4504
(210) 916-1284
Mailing address
BROOKE ARMY MEDICAL CENTER, MCHE-ZSO DEPT ORTHOPAEDICS, 3551 ROGER BROOKE DR, JBSA-FORT SAM HOUSTON, TX 78234
(210) 916-1284
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
208D00000X
General Practice Physician
Primary
0101284849
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/13/2023
Last updated
02/15/2025
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