Provider Demographics
NPI:1619078870
Name:SMITH, PAUL W (RNFA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:RNFA
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 822516
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-2516
Mailing Address - Country:US
Mailing Address - Phone:817-553-5303
Mailing Address - Fax:817-553-5304
Practice Address - Street 1:1501 NORWOOD DR
Practice Address - Street 2:SUITE 145
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3638
Practice Address - Country:US
Practice Address - Phone:817-553-5303
Practice Address - Fax:817-553-5304
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241566163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical