Individual
MR. GARWIN ALLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO/LO (ABC CERTIFIED
Contact information
Practice address
2726 FAIRFAX DR, TYLER, TX 75701-6504
(903) 520-1923
Mailing address
2726 FAIRFAX DR, TYLER, TX 75701-6504
(903) 520-1923
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
307
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079443001
CSHCN-ORTHOTICS PROVIDER
TX
05
—
CSHCN079443001
—
TX
Enumeration date
01/11/2007
Last updated
11/01/2019
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