Provider Demographics
NPI:1730504929
Name:SMITH, JOSHUA BAILEY (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:BAILEY
Last Name:SMITH
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:2410 ROUND ROCK AVE STE 150
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:512-341-8724
Practice Address - Fax:512-687-0295
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2018-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08842363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant