Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 44646 | CO |
Y | 207VX0201X | Gynecologic Oncologist | N2304 | TX |
NPI | 1164431052 |
---|---|
Provider Name | Dr. Monique Spillman |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75246-2092 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 24/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
337367201 | (05) | TX |
337367202 | (05) | TX |
41475712 | (05) | CO |
P01463666 | RAILROAD MEDICARE (01) | TX |