Smith, Timothy Keith

Smith, Timothy Keith is an individual health care provider with primary practice located at 12222 Merit Dr Ste 600 , Dallas TX 75251-3294. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Smith, Timothy Keith can be contacted via phone (972) 715-5000.

Contact Information

Primary practice address
12222 Merit Dr Ste 600 Dallas TX 75251-3294
Phone: (972) 715-5000
Fax: (972) 715-9976
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 646208 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP111819 Texas

Profile Details

NPI number 1598766842
LBN Legal business name Smith, Timothy Keith
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jul 13th, 2022 - about 4 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 1598766842 NPPES
Texas Other P01446665 RR
Texas Other 8960UG RR
Texas MEDICAID 153668204 RR
Texas MEDICAID 153668201 RR

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