Individual
RUSSELL JOSEPH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3478 CATCLAW DR, 112, ABILENE, TX 79606-8224
(325) 370-9541
Mailing address
3478 CATCLAW DR, 112, ABILENE, TX 79606-8224
(325) 370-9541
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
30586
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5759
BCBS
TX
Enumeration date
07/19/2006
Last updated
07/08/2007
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