National Provider Identifier Database

JUDSON P SMITH MD PA
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

JUDSON P SMITH MD PA
417 W MAGNOLIA AVE
FORT WORTH, TX76104
Phone: 817-338-0875
Fax: 817-870-1612
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for JUDSON P SMITH MD PA

NPI Number 1215156120
Legal business name
LBN
JUDSON P SMITH MD PA
Authorized official LISA FITZGERALD - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 04/25/2007
Last updated 11/04/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • TX License #: D9667
  • TX Medicaid: 149393401

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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