Provider Demographics
NPI:1598714719
Name:SMITHERS, VICTORIA E (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:E
Last Name:SMITHERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SUNSET RIDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-0007
Mailing Address - Country:US
Mailing Address - Phone:972-772-5450
Mailing Address - Fax:972-772-5452
Practice Address - Street 1:2701 SUNSET RIDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-0007
Practice Address - Country:US
Practice Address - Phone:972-772-5450
Practice Address - Fax:972-772-5452
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3132207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1529910-01Medicaid
TX152990106Medicaid
TX080187294OtherRR MEDICARE
TXG89587Medicare UPIN
TX1529910-01Medicaid
TX302961YKP5Medicare PIN