Provider Demographics
NPI:1396384038
Name:SMILIE, BRETT (DPT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:SMILIE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 FOX RUN DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-8816
Mailing Address - Country:US
Mailing Address - Phone:469-323-6773
Mailing Address - Fax:
Practice Address - Street 1:1206 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3976
Practice Address - Country:US
Practice Address - Phone:972-325-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-28
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3124850225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist