Dr. Mark Smith PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

H5975 Issued in TX

Legal business name

DR. MARK SMITH PA

Practice address

7100 Oakmont BVLD Suite 108
Fort Worth, TX 76132-3908

Phone

(817) 370-2657

Fax

(817) 370-2186

NPI assigned

Oct 15, 2012

Last updated

Oct 15, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Daphne Anglin

Title

Office Manager

Phone

(817) 370-2657

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1033461017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 OAKMONT BVLD SUITE 108",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323908",
            "telephone_number": "817-370-2657",
            "fax_number": "817-370-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 OAKMONT BVLD SUITE 108",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323908",
            "telephone_number": "817-370-2657",
            "fax_number": "817-370-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK SMITH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "ANGLIN",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-370-2657",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "H5975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Christopher Kim, DDS, PA (Eagle Mountain Dentistry)
• Dr. Dustin Ray, PLLC
• Dr. Gene Wong & Associates, P.a.
• Dr. I. V. Singh, PLLC (Fort Worth Critical Care)
• Dr. James T. Park
• Dr. Michael R. Guenzler P.C.
• Dr. Samuel C. Lee, PA
• Dr. Sheila Birth-Orthodontics-Keller, LLC
• Dr. Shelby Nelson DDS, LLC
• Dr. Sorokolit, M.D., P.a

• Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.