| Jesse E Smith, MD, PLLC | |
|
923 Pennsylvania Ave Ste 100 Fort Worth TX 76104-2254 | |
| (817) 806-4245 | |
| (817) 720-0094 |
| Full Name | Jesse E Smith, MD, PLLC |
|---|---|
| Speciality | Otolaryngology |
| Location | 923 Pennsylvania Ave Ste 100, Fort Worth, Texas |
| Authorized Official Name and Position | Jesse E. Smith (OWNER) |
| Authorized Official Contact | 8178064245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesse E Smith, MD, PLLC 923 Pennsylvania Ave Ste 100 Fort Worth TX 76104-2254 Ph: (817) 806-4245 | Jesse E Smith, MD, PLLC 923 Pennsylvania Ave Ste 100 Fort Worth TX 76104-2254 Ph: (817) 806-4245 |
| NPI Number | 1013753953 |
|---|---|
| Provider Enumeration Date | 07/01/2024 |
| Last Update Date | 07/10/2025 |
| Certification Date | 07/10/2025 |
| Medicare PECOS PAC ID | 3678012150 |
|---|---|
| Medicare Enrollment ID | O20240828002620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013753953 | NPI | - | NPPES |
| Provider Name | Jesse E Smith |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1194742791 PECOS PAC ID: 1153397393 Enrollment ID: I20050815000858 |
| Provider Name | Michele L. Mcpherson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225536188 PECOS PAC ID: 4688935737 Enrollment ID: I20180306001204 |
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