MEDICARE: BEVERLY K SPEARMAN OD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2804TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326020637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY K SPEARMAN OD PC

Provider Business Mailing Address
First Line	:	183 COUNTY ROAD 4171
Second Line	:
City	:	PITTSBURG
State	:	TX
Zip	:	75686-4133
Country	:	US
Telephone Number	:	903-856-2650
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 QUITMAN ST
Second Line	:
City	:	PITTSBURG
State	:	TX
Zip	:	75686-1359
Country	:	US
Telephone Number	:	903-856-2055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	05/25/2011

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Directions to “ BEVERLY K SPEARMAN OD PC” Practice Location

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