Individual
TIMOTHY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10301 GATEWAY BLVD W, EL PASO, TX 79925-7701
(309) 373-3449
Mailing address
10201 GATEWAY BLVD W STE 130, EL PASO, TX 79925-7647
(915) 594-1000
(915) 594-1007
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2016022430
MO
208600000X
Surgery Physician
Primary
T7743
TX
208600000X
Surgery Physician
TRN25581
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016022430
MISSOURI BOARD OF HEALING ARTS
MO
01
—
T7743
TEXAS MEDICAL BOARD
TX
01
—
TRN25581
FLORIDA BOARD OF MEDICINE
FL
Enumeration date
08/06/2016
Last updated
10/14/2022
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