Provider Demographics
NPI:1922203363
Name:CAMERON E SMITH, OD, PA
Entity Type:Organization
Organization Name:CAMERON E SMITH, OD, PA
Other - Org Name:TSO - MANSFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:682-429-3600
Mailing Address - Street 1:1650 HIGHWAY 287 N
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8852
Mailing Address - Country:US
Mailing Address - Phone:682-518-1177
Mailing Address - Fax:
Practice Address - Street 1:1650 HIGHWAY 287 N
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8852
Practice Address - Country:US
Practice Address - Phone:682-518-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-17
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5925TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty