Reginald Lindsey Smith, PA-C
Individual provider Active NPI Physician Assistant · Jbsa San Antonio, TX
NPI 1164578845 · NPPES record last updated Apr 20, 2020
Key facts
- NPI
- 1164578845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA00921 (TX)
- Practice address
- Brooke Army Medical Center
3551 Roger Brooke Dr
Jbsa San Antonio, TX 78234-4504 - Phone
- (210) 916-4141
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00921 | TX | Yes |
Addresses
Primary practice location
Brooke Army Medical Center
3551 Roger Brooke Dr
Jbsa San Antonio, TX 78234-4504
Mailing address
7510 Lincoln Village Dr
San Antonio, TX 78244-1517
Phone (210) 661-3037
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11644578845 | Other | MILITARY |
Other providers in Jbsa San Antonio, TX
All providers in Jbsa San Antonio, TX · Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.