Smith, Theodore D

Smith, Theodore D is an individual health care provider with primary practice located at 4100 Everett Dr Suite 400, Kyle TX 78640-6146. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Theodore D can be contacted via phone (512) 295-1333.

Contact Information

Primary practice address
4100 Everett Dr Suite 400 Kyle TX 78640-6146
Phone: (512) 295-1333
Fax: (512) 406-7327
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X L1465 Texas

Profile Details

NPI number 1114933470
LBN Legal business name Smith, Theodore D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated May 24th, 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 1114933470 NPPES
Texas MEDICAID 142148901
Texas MEDICAID 142148902

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