Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 022009 | LA |
NPI | 1679536544 |
---|---|
Provider Name | Dr. Steven Edward Spencer |
First Address | San Antonio, TX 78209-3329 |
Second Address | San Antonio, TX 78234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 29/11/2018 |