Provider Demographics
NPI:1073792438
Name:SMITH, ADAM BRIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:BRIAN
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2115 KRAMER LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4013
Mailing Address - Country:US
Mailing Address - Phone:512-978-9000
Mailing Address - Fax:
Practice Address - Street 1:1000 E 51ST ST
Practice Address - Street 2:SUITE 925
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-2232
Practice Address - Country:US
Practice Address - Phone:512-978-9940
Practice Address - Fax:512-901-9702
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044968207R00000X, 207R00000X
TXP9460207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTFS0179778OtherDEA