Organization
HERITAGE NETWORK PHYSICIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD SMITH D.O. (PHYSICIAN)
(817) 282-0917
Entity
Organization
Contact information
Practice address
729 BEDFORD EULESS RD W, SUITE 108, HURST, TX 76053-3939
(817) 282-0917
(817) 282-7934
Mailing address
729 BEDFORD EULESS RD W, SUITE 108, HURST, TX 76053-3939
(817) 282-0917
(817) 282-7934
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E1757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104410902
—
TX
Enumeration date
05/11/2009
Last updated
05/11/2009
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