Individual
DONNA SMITH
Active
Individual
DONNA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1091072
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172915401
—
TX
01
—
8T4435
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
08/03/2006
Last updated
12/14/2021
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