Provider Demographics
NPI:1235474834
Name:MICHAEL L. SMITH, M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL L. SMITH, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-838-2626
Mailing Address - Street 1:3345 PLAZA 10 DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2554
Mailing Address - Country:US
Mailing Address - Phone:409-838-2626
Mailing Address - Fax:409-838-1980
Practice Address - Street 1:3345 PLAZA 10 DR
Practice Address - Street 2:SUITE E
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2554
Practice Address - Country:US
Practice Address - Phone:409-838-2626
Practice Address - Fax:409-838-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty