Provider Demographics
NPI:1366474454
Name:SMITH, DANIEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4716 ALLIANCE BLVD
Mailing Address - Street 2:SUITE 750
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5371
Mailing Address - Country:US
Mailing Address - Phone:469-800-6000
Mailing Address - Fax:469-800-6001
Practice Address - Street 1:4716 ALLIANCE BLVD
Practice Address - Street 2:SUITE 750
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5371
Practice Address - Country:US
Practice Address - Phone:469-800-6000
Practice Address - Fax:469-800-6001
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL9487207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1671463-01Medicaid
TX1671463-02Medicaid
TX167146303Medicaid
TX1671463-01Medicaid
TX363279YK6JMedicare PIN
TX8C1604Medicare PIN
TX1671463-02Medicaid