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Individual

DR. SAMUEL SMILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G5623
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00J245
MEDICARE GROUP
TX
01
083133101
MEDICAID GROUP
TX
01
10016858
AMERIGROUP
TX
05
124458403
TX
01
300034183
MEDICARE RAILROAD
TX
01
CS7910
MEDICARE RAILROAD GROUP
TX
Enumeration date
05/28/2006
Last updated
07/16/2013
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