Provider Demographics
NPI:1568429629
Name:SMITH, HARRY GERHART (DO)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:GERHART
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:PO BOX 2317
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76097-2317
Mailing Address - Country:US
Mailing Address - Phone:817-687-9517
Mailing Address - Fax:800-466-0755
Practice Address - Street 1:1526 COUNTY ROAD 529
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-1008
Practice Address - Country:US
Practice Address - Phone:817-687-9517
Practice Address - Fax:800-466-0755
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4542207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB43226Medicare UPIN
TX0538180001Medicare NSC
TX89X992Medicare PIN