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Organization

GREGORY W. SMITH MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS KIMMY LIDBOM-OXFORD (BILLING COORDINATOR)
(956) 465-1091
Entity
Organization

Contact information

Practice address
602 KAIMALI DR, HARLINGEN, TX 78550-0233
(956) 412-1100
(956) 412-1102
Mailing address
PO BOX 1768, SAN ANTONIO, TX 78296-1768
(956) 542-1850
(956) 542-2879

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
K5700
TX
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0040SM
BLUE CROSS BLUE SHIELD
TX
05
207043501
TX
01
DP8222
MEDICARE - RAIL ROAD
TX
Enumeration date
06/03/2009
Last updated
06/12/2024
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