Individual
BRYAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
218 SHAHAN TRL, WHITEHOUSE, TX 75791-1216
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
878291
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1190230
TX
367500000X
Certified Registered Nurse Anesthetist
152624
TX
Other
Enumeration date
12/17/2024
Last updated
02/12/2025
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