Individual
DR. GARY L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5402 S STAPLES ST, STE 205, CORPUS CHRISTI, TX 78411-4670
(361) 882-3487
(361) 882-3811
Mailing address
PO BOX 60170, CORPUS CHRISTI, TX 78466-0170
(361) 882-3487
(361) 882-3811
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
MDH3177
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120650004
—
TX
01
—
84530Y
BCBS OF TX PROVIDER NO
TX
Enumeration date
06/08/2005
Last updated
06/15/2010
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