Individual
MS. LOIS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5832 MONTERREY DR, FORT WORTH, TX 76112-3980
(817) 429-5785
(817) 429-5785
Mailing address
5832 MONTERREY DR, FORT WORTH, TX 76112-3980
(817) 429-5785
(817) 429-5785
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
116794
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000688000
TDADS
TX
Enumeration date
03/06/2007
Last updated
12/01/2021
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