Provider Demographics
NPI:1194746735
Name:SMITH, KAREN V (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:V
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:512-352-5251
Mailing Address - Fax:512-352-5146
Practice Address - Street 1:12436 GREGG MANOR RD
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653-4138
Practice Address - Country:US
Practice Address - Phone:512-654-4400
Practice Address - Fax:512-654-4401
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2820207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198308203Medicaid
TX198308203Medicaid