Provider Demographics
NPI:1326144114
Name:SMITH, STANLEY GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:GRANT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1439 HANZ DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2567
Mailing Address - Country:US
Mailing Address - Phone:830-606-9099
Mailing Address - Fax:830-608-0717
Practice Address - Street 1:1439 HANZ DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2567
Practice Address - Country:US
Practice Address - Phone:830-606-9099
Practice Address - Fax:830-608-0717
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2019-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH4709207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0049BMMedicare ID - Type UnspecifiedPROVIDER NUMBER