Provider Demographics
NPI:1477866721
Name:JOHN R SMYER MD PLLC
Entity Type:Organization
Organization Name:JOHN R SMYER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SMYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-368-9631
Mailing Address - Street 1:10210 FRANKFORD AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:806-368-9631
Mailing Address - Fax:806-368-9633
Practice Address - Street 1:4213 85TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1976
Practice Address - Country:US
Practice Address - Phone:806-368-9631
Practice Address - Fax:806-368-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBS5177589OtherDEA
TXH31606Medicare UPIN