Smith, Shannon L
Smith, Shannon L is an individual health care provider with primary practice located at 3302 Ne Stallings Dr , Nacogdoches TX 75965-8727. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Smith, Shannon L can be contacted via phone (936) 564-3600.Contact Information
Primary practice address
3302 Ne Stallings Dr
Nacogdoches TX 75965-8727
Phone: (936) 564-3600
Fax: (936) 564-3770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | H2797 | Texas |
Profile Details
| NPI number | 1598876237 |
|---|---|
| LBN Legal business name | Smith, Shannon L |
| Credentials | MD FACS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | May 12th, 2008 - about 16 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 | 1598876237 | NPPES |
| Texas | Other | 8BB470 | BCBS |
| Texas | MEDICAID | 127607302 | BCBS |
| Texas | Other | 00Y956 | BCBS |
| Texas | Other | 8F7718 | BCBS |
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