Provider Demographics
NPI:1508058900
Name:SMITH, JAMES A (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 OXFORD DR STE 104
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5479
Mailing Address - Country:US
Mailing Address - Phone:830-214-0300
Mailing Address - Fax:830-214-0397
Practice Address - Street 1:479 OXFORD DR STE 104
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5479
Practice Address - Country:US
Practice Address - Phone:830-214-0300
Practice Address - Fax:830-214-0397
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008631207RC0000X
MI5101016679207RC0000X
TXT2757207RC0000X, 207RI0011X
IA3806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH002062OtherMEDICARE PIN
OHP00962319OtherRAILROAD MEDICARE
OH3144412Medicaid