Provider Demographics
NPI:1063308989
Name:SMITH, GINGER (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:TX
Mailing Address - Zip Code:77360-0566
Mailing Address - Country:US
Mailing Address - Phone:936-252-2545
Mailing Address - Fax:
Practice Address - Street 1:1872 FM 3186
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:TX
Practice Address - Zip Code:77360-7550
Practice Address - Country:US
Practice Address - Phone:936-433-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX690427250042246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy