Ralph Smith III, LCDC

Primary specialty

Other TechnicianTaxonomy code 247200000X

License

9305 Issued in TX

Practice address

2200 Bergquist Dr
59 MHS Sgow Ste 1
Lackland Afb, TX 78236

Phone

(210) 292-7722

Fax

(210) 292-2520

NPI assigned

Aug 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1871784249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 N LOOP 1604 W",
            "address_2": "APT 124",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492595",
            "telephone_number": "210-292-7722",
            "fax_number": "210-292-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "59 MHS SGOW STE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-7722",
            "fax_number": "210-292-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RALPH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "TX",
            "license": "9305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Silverman, D.D.S., M.S.D.
• Angela Keller Simonowicz, AUD
• Catherine Patricia Skerrett, RN, MSN, FNP
• Karen Melanie Sky, M.D.
• Nicole Alexandra Smith, DMD
• William Marcus Smith, PA
• Rachel Nicole Stamp-Siegfried, M.D.
• Ryan Stewart, PHARMD
• Laura E Street
• Cameron Mitchell Thurman, M.D.

• Other Technician in Lackland Afb, TX
• Providers in Lackland Afb, TX by specialty
• Other Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.