Healthcare Provider Details

I. General information

NPI: 1518176064
Provider Name (Legal Business Name): TIMOTHY PAUL SPEARS DC PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 W RANDOL MILL RD #103
ARLINGTON TX
76012
US

IV. Provider business mailing address

1119 W RANDOL MILL RD #103 TIMOTHY P SPEARS DC PA
ARLINGTON TX
76012
US

V. Phone/Fax

Practice location:
  • Phone: 817-461-6656
  • Fax: 817-461-6301
Mailing address:
  • Phone: 817-461-6656
  • Fax: 817-461-6301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC8538TX
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: