Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | M9673 | TX |
N | 2086S0129X | Vascular Surgeon | M9673 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | M9673 | TX |
NPI | 1184782120 |
---|---|
Provider Name | Dr. Jon Phillip Spiers SR. |
First Address | Houston, TX 77005-3842 |
Second Address | Houston, TX 77005-3842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 04/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G33377 | (02) |