Provider Demographics
NPI:1710939756
Name:SMITH, DEAN E (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:E
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10400 VISTA DEL SOL DR STE 204
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7924
Mailing Address - Country:US
Mailing Address - Phone:915-857-6699
Mailing Address - Fax:915-856-7268
Practice Address - Street 1:10400 VISTA DEL SOL DR STE 204
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7924
Practice Address - Country:US
Practice Address - Phone:915-857-6699
Practice Address - Fax:915-856-7268
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2019-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ3616207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2286Medicare UPIN