Individual
MR. RANDALL S SMITH I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
8402 CROSS PARK DR, AUSTIN, TX 78754-4595
(512) 697-8500
Mailing address
289 LAKE WASHINGTON DR, KYLE, TX 78640-5178
(806) 438-8923
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11317
TX
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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