Provider Demographics
NPI:1942658224
Name:AUBREY L SMITH MD III
Entity Type:Organization
Organization Name:AUBREY L SMITH MD III
Other - Org Name:AUBREY L SMITH MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:LYNDOL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:806-359-0718
Mailing Address - Street 1:1600 S COULTER ST STE B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-0703
Mailing Address - Country:US
Mailing Address - Phone:806-359-0718
Mailing Address - Fax:806-359-9613
Practice Address - Street 1:1600 S COULTER ST STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-0703
Practice Address - Country:US
Practice Address - Phone:806-359-0718
Practice Address - Fax:806-359-9613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8421174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty