Provider Demographics
NPI:1336140680
Name:SMITH, WILLIAM CARL (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CARL
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8715 VILLAGE DR
Mailing Address - Street 2:STE 618
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5407
Mailing Address - Country:US
Mailing Address - Phone:210-967-7377
Mailing Address - Fax:210-967-6502
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:STE 618
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5407
Practice Address - Country:US
Practice Address - Phone:210-967-7377
Practice Address - Fax:210-967-6502
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG8427207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology