Organization
EILEEN A. SMITH M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVONNIE P ESTRADA (OFFICE MANAGER)
(210) 967-0515
Entity
Organization
Contact information
Practice address
8601 VILLAGE DR, 118, SAN ANTONIO, TX 78217-5512
(210) 967-0515
(210) 655-9697
Mailing address
PO BOX 34567, SAN ANTONIO, TX 78265-4567
(210) 967-0515
(210) 655-9697
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
TXJ1141
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002MG
BCBS
TX
05
—
171599701
—
TX
01
—
DN8900
MEDICARE RAILROAD
TX
Enumeration date
09/27/2007
Last updated
01/07/2009
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