Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 0660 | TX |
NPI | 1205868106 |
---|---|
Provider Name | Marc P Spector |
First Address | Humble, TX 77338-4229 |
Second Address | Humble, TX 77338-4229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 01/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00ET48 | MEDICARE PTAN (01) | TX |
00U64X | MEDICARE PTAN (01) | TX |
112203801 | (05) | TX |
T16033 | (02) | TX |