Smyrl, Jeremy A

Smyrl, Jeremy A is an individual health care provider with primary practice located at 955 Southbend Trl , Southlake TX 76092-6301. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Smyrl, Jeremy A can be contacted via phone (682) 429-5113.

Contact Information

Primary practice address
955 Southbend Trl Southlake TX 76092-6301
Phone: (682) 429-5113
Fax: (855) 429-5113
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X TL2236 Colorado
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X N3319 Texas

Profile Details

NPI number 1457503807
LBN Legal business name Smyrl, Jeremy A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2008
Last updated Jul 18th, 2017 - about 7 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 1457503807 NPPES
Texas MEDICAID 206079001
Texas MEDICAID 206079002
Texas MEDICAID 206079003
Texas MEDICAID 206079006

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