Individual
BETTY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 S MAIN ST STE 1500B, FORT WORTH, TX 76104-4802
(817) 321-4806
(817) 850-8502
Mailing address
1101 S MAIN ST STE 1500B, FORT WORTH, TX 76104-4802
(817) 321-4806
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
85279
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85279
LVN
TX
Enumeration date
06/23/2014
Last updated
06/23/2014
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