Individual
JORDAN K SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-4262
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
Q6470
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3555558312
—
TX
05
—
355558313
—
TX
01
—
481599YSP
MEDICARE
TX
01
—
481599YSV
MEDICARE
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-0818167-051
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
8GY137
BCBS
TX
01
—
P01878587
MEDICARE RAIL ROAD
TX
01
—
P01878809
MEDICARE RAIL ROAD
TX
Enumeration date
05/02/2014
Last updated
04/13/2026
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