Individual
PAMELA S. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 84658, DALLAS, TX 75284-0001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
236425
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007981-02
—
TX
01
—
8N9151
BLUE SHIELD
TX
01
—
P00269386
RR/MEDICARE
TX
Enumeration date
04/05/2006
Last updated
04/09/2014
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