Provider Demographics
NPI:1770641938
Name:SMREKAR, J. DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:J.
Middle Name:DOUGLAS
Last Name:SMREKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7734
Mailing Address - Country:US
Mailing Address - Phone:972-867-6400
Mailing Address - Fax:972-519-0391
Practice Address - Street 1:3709 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7734
Practice Address - Country:US
Practice Address - Phone:972-867-6400
Practice Address - Fax:972-519-0391
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7182207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD69124Medicare UPIN
TXEY51Medicare ID - Type Unspecified