Provider Demographics
NPI:1215044870
Name:SMITH, DON A (PHD)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:A
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 I35N
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-3408
Mailing Address - Country:US
Mailing Address - Phone:940-382-0512
Mailing Address - Fax:940-383-3105
Practice Address - Street 1:4228 I35N
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-3408
Practice Address - Country:US
Practice Address - Phone:940-382-0512
Practice Address - Fax:940-383-3105
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1452103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical