Provider Demographics
NPI:1467207415
Name:KAUR, SMILE PREET
Entity type:Individual
Prefix:
First Name:SMILE
Middle Name:PREET
Last Name:KAUR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WARRIOR LANE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056
Mailing Address - Country:US
Mailing Address - Phone:601-502-3067
Mailing Address - Fax:
Practice Address - Street 1:902 PRESKITT RD STE 300
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-4124
Practice Address - Country:US
Practice Address - Phone:940-626-1864
Practice Address - Fax:940-626-1865
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant