Jeremy Smith

NPI #1023478468 in Fort Worth, Texas

Provider Information

NPI Number: 1023478468
Entity Type: Individual
Name: Jeremy Smith
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Enumeration Date: Feb 27, 2016
Last Updated: Mar 27, 2016

Practice Location

Address: 3310 RUNNELS ST
City: Fort Worth
State: Texas
ZIP Code: 76106-6421
Phone: (469) 237-8614

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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