Individual
KEITH R. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP, BC
Contact information
Practice address
2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
(210) 292-6225
Mailing address
10906 ROCKY TRL, SAN ANTONIO, TX 78249-4133
(210) 912-8547
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
530772
TX
Other
Enumeration date
01/24/2006
Last updated
04/26/2011
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