Individual
MARK A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-8095
(214) 648-3111
Mailing address
5323 HARRY HINES BLVD STOP 7200, DALLAS, TX 75390-8095
(214) 648-3111
(402) 559-9840
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2869
AZ
363AM0700X
Medical Physician Assistant
Primary
16959
TX
363AM0700X
Medical Physician Assistant
686
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
949901
—
AZ
Enumeration date
11/14/2006
Last updated
01/09/2024
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