Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | N6038 | TX |
N | 2081S0010X | Sports Medicine | N6038 | TX |
N | 213ES0000X | Sports Medicine | N6038 | TX |
NPI | 1033313556 |
---|---|
Provider Name | Robert James Spicer |
First Address | Dallas, TX 75222-2093 |
Second Address | Cedar Hill, TX 75104-2117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 01/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8X9705 | BCBS OF TEXAS (01) | TX |