Individual
MARK CHRISTOPHER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
3621 22ND ST STE 400, LUBBOCK, TX 79410-1302
(809) 794-8484
(806) 794-8498
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP126468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38225069
—
NM
01
—
8383NS
BCBS
TX
Enumeration date
09/17/2014
Last updated
12/01/2015
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