MEDICARE: AMANDA R SPOERL

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	246ZC0007X	Surgical Assistant	208462	TX

General Provider Information

NPI Number	:	1912643206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA R SPOERL

Provider Business Mailing Address
First Line	:	13825 BIRCHLAWN DR
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-3513
Country	:	US
Telephone Number	:	214-616-9327
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 E LEMMON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-2833
Country	:	US
Telephone Number	:	214-443-3000
Fax Number	:

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

Provider Enumeration Date	:	05/09/2022
Last Update Date	:	05/10/2022

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Directions to “ AMANDA R SPOERL ” Practice Location

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