Provider Demographics
NPI:1992788079
Name:SMITH, RICK D (DC)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:D
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 S GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3436
Mailing Address - Country:US
Mailing Address - Phone:806-342-3333
Mailing Address - Fax:806-350-7792
Practice Address - Street 1:2901 S GEORGIA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3436
Practice Address - Country:US
Practice Address - Phone:806-342-3333
Practice Address - Fax:806-350-7792
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169494501Medicaid
TXV02407Medicare UPIN
TX169494501Medicaid