Smith, Ava Gale

Smith, Ava Gale is an individual health care provider with primary practice located at 3840 Hulen St Htn, Client Accounting, Fort Worth TX 76107-7277. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Smith, Ava Gale can be contacted via phone (817) 569-4396.

Contact Information

Primary practice address
3840 Hulen St Htn, Client Accounting Fort Worth TX 76107-7277
Phone: (817) 569-4396
Fax: (817) 569-4517
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 235655 Texas
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 235655 Texas

Profile Details

NPI number 1396806774
LBN Legal business name Smith, Ava Gale
Credentials R.N., P.M.H.N.P
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated May 1st, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396806774 NPPES
Texas Other 86N92S BLUE CROSS BLUE SHIELD OF TEXAS
Texas MEDICAID 088277101 BLUE CROSS BLUE SHIELD OF TEXAS
Texas MEDICAID 088277103 BLUE CROSS BLUE SHIELD OF TEXAS
Texas MEDICAID 088277102 BLUE CROSS BLUE SHIELD OF TEXAS

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