Provider Demographics
NPI:1003976952
Name:SMITH, RONALD K (OD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:K
Last Name:SMITH
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:820 E CARTWRIGHT RD
Mailing Address - Street 2:STE 150
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-6000
Mailing Address - Country:US
Mailing Address - Phone:972-288-2520
Mailing Address - Fax:972-288-2236
Practice Address - Street 1:820 E CARTWRIGHT RD
Practice Address - Street 2:STE 150
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-6000
Practice Address - Country:US
Practice Address - Phone:972-288-2520
Practice Address - Fax:972-288-2236
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX3688T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU06299Medicare UPIN