Healthcare Provider Details

I. General information

NPI: 1679078075
Provider Name (Legal Business Name): SP PAIN PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 STATE HIGHWAY 121 STE 420
FRISCO TX
75035-9346
US

IV. Provider business mailing address

PO BOX 674293
DALLAS TX
75267-4293
US

V. Phone/Fax

Practice location:
  • Phone: 469-559-5880
  • Fax:
Mailing address:
  • Phone: 832-945-3963
  • Fax: 866-407-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT JAMES SPICER
Title or Position: PRESIDENT
Credential: MD
Phone: 469-559-5880