JUDSON P SMITH MD PA
Medical Practice at Magnolia Ave, Fort Worth, TX

License number
Texas D9667
Category
Medical Practice
Type
Specialist
Owner
Name: MRS. LISA M FITZGERALD
Title: OFFICE MANAGER
Phone: (817) 338-4081
Address
Address
417 W Magnolia Ave, Fort Worth, TX 76104
National Provider ID: 1215156120
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JUDSON P. SMITH, M.D. PA

Fort Worth, TX

Status:
Inactive
Doing business as:
Judson P. Smith, M.D. PA
Registration:
Oct 11, 1978
Addresses:
417 W Magnolia Ave, Fort Worth, TX 76104 (Mailing)
1350 S Main St, Fort Worth, TX 76104
State ID:
0080447503
Business type:
Professional Association
Director , Members:
Judson P. Smith President , Director , Member, inactive,Kathryn Susan Smith Director , Member, inactive
TIN:
17516218710

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