Individual
JUDSON P SMITH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PA
Contact information
Practice address
417 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 338-4081
(817) 870-1612
Mailing address
417 W MAGNOLIA AVE, FORT WORTH, TX 76104
(817) 338-4081
(817) 870-1612
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D9667
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004246771
AETNA
TX
01
—
1215156120
BLUE CROSS BLUE SHIELD
TX
05
—
1493934-01
—
TX
01
—
180000666
RAILROAD MEDICARE
TX
Enumeration date
04/12/2006
Last updated
07/20/2010
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