Provider Demographics
NPI:1154355626
Name:SMITH, DAVID LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LAWRENCE
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 W 15TH ST STE 425
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5848
Mailing Address - Country:US
Mailing Address - Phone:972-696-0030
Mailing Address - Fax:972-696-0037
Practice Address - Street 1:4001 W 15TH ST STE 425
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5848
Practice Address - Country:US
Practice Address - Phone:972-696-0030
Practice Address - Fax:972-696-0037
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC364322086S0102X
TXL26632086S0127X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L5692Medicare PIN
TXF56624Medicare UPIN