Provider Demographics
NPI:1982192274
Name:SMITH, TONI DANIELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TONI
Middle Name:DANIELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 GREAT TRINITY FOREST WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7732
Mailing Address - Country:US
Mailing Address - Phone:469-547-2222
Mailing Address - Fax:
Practice Address - Street 1:3232 GREAT TRINITY FOREST WAY STE 102A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216
Practice Address - Country:US
Practice Address - Phone:469-547-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX406461835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40646OtherSTATE LICENSE PHARMACY