Individual
DR. KYLE JAMES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1783 TROUP HWY, TYLER, TX 75701-5869
(903) 595-2283
(903) 597-2238
Mailing address
1783 TROUP HWY, TYLER, TX 75701-5869
(903) 595-2283
(903) 597-2238
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M2117
TX
207RC0000X
Cardiovascular Disease Physician
M2117
TX
207RI0011X
Interventional Cardiology Physician
Primary
M2117
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203368001
—
TX
01
—
8F7574
BCBS
TX
01
—
P00736592
RR MEDICARE
TX
Enumeration date
08/11/2006
Last updated
05/05/2023
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