Smith, Jesse E
Smith, Jesse E is an individual health care provider with primary practice located at 923 Pennsylvania Avenue Suite 100, Fort Worth TX 76104-2254. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Smith, Jesse E can be contacted via phone (817) 920-0484.Contact Information
Primary practice address
923 Pennsylvania Avenue Suite 100
Fort Worth TX 76104-2254
Phone: (817) 920-0484
Fax: (817) 920-0068
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | L1204 | Texas |
Profile Details
| NPI number | 1194742791 |
|---|---|
| LBN Legal business name | Smith, Jesse E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jan 23rd, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194742791 | NPPES |
| Other | P00413563 | RAILROAD MEDICARE | |
| Other | 176348402 | RAILROAD MEDICARE | |
| MEDICAID | 176348401 | RAILROAD MEDICARE |
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