Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1467502039 |
---|---|
Provider Name | Dr. Kevan M Spencer |
First Address | El Paso, TX 79920-5001 |
Second Address | El Paso, TX 79920-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 08/07/2007 |