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:
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Health care specialties

SpecialtyCodeLicense #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 3 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 1194742791 NPPES
Other P00413563 RAILROAD MEDICARE
Other 176348402 RAILROAD MEDICARE
MEDICAID 176348401 RAILROAD MEDICARE

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