Individual
MS. SHANNON L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD FACS
Contact information
Practice address
3302 NE STALLINGS DR, NACOGDOCHES, TX 75965-8727
(936) 564-3600
(936) 564-3770
Mailing address
3302 NE STALLINGS DR, NACOGDOCHES, TX 75965-8727
(936) 564-3600
(936) 564-3770
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
H2797
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y956
MEDICARE GROUP
TX
05
—
127607302
—
TX
01
—
8BB470
BCBS
TX
01
—
8F7718
MEDICARE ID; TYPE UNSPECIFIED
TX
Enumeration date
08/31/2006
Last updated
06/26/2025
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