Individual
KORDE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 606-6400
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1136624
TX
Other
Enumeration date
09/18/2023
Last updated
09/27/2023
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