P Praxis·MD
● Active Type 1 · Individual

MS. Maryellen Warro Smith, P.A.

Physician Assistant·Tyler, TX· NPI 1275648834 · Enumerated 2006 · 19 years on NPI
Smith is 1 of 101 physician assistant providers in Tyler and 1 of 11022 in Texas.
NPI age
19 years
Enumerated 2006-08-21
Primary specialty
Physician Assistant
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2018-02-28
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 11022 active physician assistant providers in Texas.

NPI age
19 years
↑ 9 yr above median (10 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
23% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-08Enumerated in NPPES
2006 2026

Where they practice

Practice location
5414 S Broadway Ave
Tyler, TX 757031335
📞 9035811601
Mailing address
1905 S Donnybrook Ave
Tyler, TX 757014236
📞 9035973140fax 9035955693

Specialties

  • Physician Assistant Primary
    A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
    TX license #PA04930 taxonomy 363A00000X

Identifiers

TypeValueNotes
01 (TX) 75-2616977-001 TRICARE
01 (TX) 8544ND BCBS
01 (TX) 75-1976930-005 TRICARE
01 (TX) 75-2616977-028 TRICARE
01 (TX) 8547ND BCBS
05 (TX) 337319301
01 (TX) 75-0818167-048 TRICARE
01 (TX) 75-0818167-044 TRICARE
01 (TX) 75-0818167-015 TRICARE
01 (TX) 75-0818167-022 TRICARE
01 (TX) 8545ND BCBS
05 (TX) 337319303
01 (TX) 75-2616977-002 TRICARE
01 (TX) 8546ND BCBS
05 (TX) 337319302
05 (TX) 337319304

Practice context

Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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