Provider Demographics
NPI:1952728578
Name:SMITH, SHALYNN (DSCPT)
Entity Type:Individual
Prefix:
First Name:SHALYNN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:DSCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 PURSLEY RD
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4734
Mailing Address - Country:US
Mailing Address - Phone:512-923-3248
Mailing Address - Fax:
Practice Address - Street 1:1900 PURSLEY RD
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4734
Practice Address - Country:US
Practice Address - Phone:512-923-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1123081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist