Provider Demographics
NPI:1265684468
Name:DR. ROBERT C. SMITH, M.D., P.A.
Entity Type:Organization
Organization Name:DR. ROBERT C. SMITH, M.D., P.A.
Other - Org Name:DENTON DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:940-382-1718
Mailing Address - Street 1:209 N BONNIE BRAE ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3708
Mailing Address - Country:US
Mailing Address - Phone:940-382-1718
Mailing Address - Fax:940-380-9222
Practice Address - Street 1:209 N BONNIE BRAE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3708
Practice Address - Country:US
Practice Address - Phone:940-382-1718
Practice Address - Fax:940-380-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4529207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty