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Individual

MR. FAISON HEATHMAN SMITH IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCDC, ADCIII

Contact information

Practice address
801 W NOLANA AVE, SUITE 101, MCALLEN, TX 78504-3034
(956) 994-1428
(956) 994-1487
Mailing address
3216 SWALLOW AVE, MCALLEN, TX 78504-4925
(956) 630-3405

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1765
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8840BH
BC-BS
TX
Enumeration date
02/16/2007
Last updated
10/04/2010
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