Provider Demographics
NPI:1366809964
Name:SMITH, BARRY (DC)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
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 1:1089 W EXCHANGE PKWY
Mailing Address - Street 2:#2105
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-7034
Mailing Address - Country:US
Mailing Address - Phone:940-224-2914
Mailing Address - Fax:
Practice Address - Street 1:1089 W EXCHANGE PKWY
Practice Address - Street 2:#2105
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-7034
Practice Address - Country:US
Practice Address - Phone:940-224-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor