Provider Demographics
NPI:1629230552
Name:SMITH, WILLIAM A JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2021 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2219
Mailing Address - Country:US
Mailing Address - Phone:972-253-4354
Mailing Address - Fax:972-253-4218
Practice Address - Street 1:2021 N MACARTHUR BLVD
Practice Address - Street 2:STE 325
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061
Practice Address - Country:US
Practice Address - Phone:972-253-4210
Practice Address - Fax:972-253-2510
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2018-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP7572208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3248452 01Medicaid
TX311597YSFZMedicare PIN