Individual
GREGORY HEATH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
800 5TH AVE STE 500, FORT WORTH, TX 76104-7304
(817) 250-4280
Mailing address
800 5TH AVE STE 500, FORT WORTH, TX 76104-7304
(817) 250-4280
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
J3905
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130841307
—
TX
05
—
130841309
—
TX
Enumeration date
06/07/2006
Last updated
02/21/2022
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