Provider Demographics
NPI:1053534982
Name:SMITH, HOBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:HOBERT
Middle Name:L
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 PECOS ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7417
Mailing Address - Country:US
Mailing Address - Phone:956-483-9099
Mailing Address - Fax:866-313-0961
Practice Address - Street 1:2104 PECOS ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-7417
Practice Address - Country:US
Practice Address - Phone:956-483-9099
Practice Address - Fax:866-313-0961
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4949207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE25151Medicare UPIN