Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | G6875 | TX |
N | 207PP0204X | Pediatric Emergency Physician | G6875 | TX |
Y | 208000000X | Pediatrician | G6875 | TX |
NPI | 1063401669 |
---|---|
Provider Name | Dr. Thomas Steven Spurgat |
First Address | Boerne, TX 78006-8021 |
Second Address | Selma, TX 78154-3372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 18/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E77607 | (02) |