Individual
ROBERT WAYNE SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2608 MCDONALD RD, STE 100, TYLER, TX 75701-5934
(903) 595-5514
Mailing address
2608 MCDONALD RD, STE 100, TYLER, TX 75701-5934
(903) 595-5514
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
J7380
TX
207RI0011X
Interventional Cardiology Physician
Primary
J7380
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045056102
UNITED HEALTHCARE
TX
05
—
045056102
—
TX
01
—
7751083
AETNA
TX
01
—
8C0850
BCBS
TX
Enumeration date
09/14/2005
Last updated
04/26/2017
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