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Contact Information

KELLY J SMITH MD PA
5282 MEDICAL DR
SUITE 120
SAN ANTONIO, TX78229-4849
 Phone: 210-615-3700
 Fax: 210-615-3701
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Pulmonology

2080P0214X 37 Physician/Pediatric Medicine
 

Sleep Medicine

2080S0012X 37 Physician/Pediatric Medicine
 

Sleep Medicine

207RS0012X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KELLY J SMITH MD PA

NPI Number 1083829139
LBN Legal business name KELLY J SMITH MD PA
Authorized official KELLY SMITH - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 05/11/2007
Last updated 07/30/2008 - About 18 years ago
Identifiers
TX License # M3394
TX Medicaid 191771801
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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