Individual
MR. RALPH SMITH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
2200 BERGQUIST DR, 59 MHS SGOW STE 1, LACKLAND AFB, TX 78236
(210) 292-7722
(210) 292-2520
Mailing address
8910 N LOOP 1604 W, APT 124, SAN ANTONIO, TX 78249-2595
(210) 292-7722
(210) 292-2520
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
9305
TX
Other
Enumeration date
08/09/2007
Last updated
08/09/2007
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