AMITY LYNN SMITH PLLC NPI 1114323987

NPI Information

  • NPI: 1114323987
  • Provider Name: AMITY LYNN SMITH, PLLC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Doing Business As: REVOLUTION WELLNESS AND PREVENTION
  • Address: 601 ZENA RUCKER RD
    STE 105
    SOUTHLAKE, TX
    ZIP 76092
  • Phone: (817) 466-2837

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NPI Details

AMITY LYNN SMITH, PLLC is a medical specialty clinic center in Southlake, TX. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). AMITY LYNN SMITH, PLLC NPI is 1114323987. The provider is registered as an organization entity type.
The provider Is Doing Business As Revolution Wellness And Prevention.

The provider's business location address is:

601 ZENA RUCKER RD
STE 105
SOUTHLAKE, TX
ZIP 76092-386
Phone: (817) 466-2837
Fax: (817) 488-6335

The provider's authorized official is Amity Lynn Smith .
The authorized official title is Owner and has the following contact phone number (817) 488-2837.

The enumeration date for this NPI number is 11/6/2014 and was last updated on 11/6/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyL9802TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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