Individual
BANE L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3920 W WHEATLAND RD STE 152, DALLAS, TX 75237-3404
(214) 467-0432
(214) 467-0635
Mailing address
3920 W WHEATLAND RD STE 152, DALLAS, TX 75237-3404
(214) 467-0432
(214) 467-0635
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H2968
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116706601
—
TX
Enumeration date
07/17/2006
Last updated
09/27/2021
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