Organization
TEXAS SPECIALTY PHYSICIANS
Active
Other names
Smith General Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (ADMINISTRATOR)
(502) 596-6063
Entity
Organization
Contact information
Practice address
2203 W LAMPASAS ST, SUITE 205, ENNIS, TX 75119-5644
(785) 843-2010
(785) 843-1639
Mailing address
2203 W LAMPASAS ST, SUITE 205, ENNIS, TX 75119-5644
(785) 843-2010
(785) 843-1639
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
N5407
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2093718-01
—
TX
Enumeration date
11/18/2009
Last updated
06/25/2025
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