NPI 1083029714

Tiffany Smith

Practitioner Health Maintenance Organization Fort Worth, TX

Practice location

Address: 1500 Circle Dr, Fort Worth, TX 76119
Phone: (817) 423-6320
Mailing address: 4309 Kyleigh Dr, Fort Worth, TX 76123

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 703688 (TX)

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Registry record

NPI: 1083029714
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Jun 2014
Record last updated: 20 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.