Individual
GRAYSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1305 WONDER WORLD DR, STE 206, SAN MARCOS, TX 78666-7546
(512) 396-1525
(512) 353-2530
Mailing address
1305 WONDER WORLD DR, STE 206, SAN MARCOS, TX 78666-7546
(512) 396-1525
(512) 353-2530
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H2792
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042439202
—
TX
01
—
8R5960
BCBS
TX
Enumeration date
06/15/2006
Last updated
11/19/2009
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