Jared Taylor Smith, PA-C
Physician Assistant in Fort Worth, TX. Individual provider (NPI-1).
NPI number1669082467
StatusActive
Last updated in NPPESAug 18, 2023
Details
- NPI
- 1669082467
- Entity type
- Individual (NPI-1)
- Name
- Jared Taylor Smith
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 6, 2020
- Certification date
- Aug 18, 2023
- Last updated
- Aug 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA14991 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
6301 Harris Pkwy Ste 300Fort Worth, TX 76132-4266
Phone 817-877-3432
Mailing address
1124 Cropout WayHaslet, TX 76052-5887
Phone 806-759-7624
Other practice locations
3600 N Garfield St
Midland, TX 79705-6329
Midland, TX 79705-6329
Phone 806-759-7624
909 9th Ave Ste 200
Fort Worth, TX 76104-3916
Fort Worth, TX 76104-3916
Phone 817-332-7867
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