Provider Demographics
NPI:1558826933
Name:KAMILIA TAGI SMITH MD PLLC
Entity Type:Organization
Organization Name:KAMILIA TAGI SMITH MD PLLC
Other - Org Name:CHARLESTON HOUSE GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMILIA
Authorized Official - Middle Name:TAGI
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-477-9239
Mailing Address - Street 1:3611 SWISS AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6245
Mailing Address - Country:US
Mailing Address - Phone:214-821-3313
Mailing Address - Fax:214-247-1160
Practice Address - Street 1:3611 SWISS AVE STE 201
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6245
Practice Address - Country:US
Practice Address - Phone:214-477-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty