Healthcare Provider Details

I. General information

NPI: 1922554138
Provider Name (Legal Business Name): TINA SPRUELL FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 STATE HIGHWAY 75 N STE 130
HUNTSVILLE TX
77320-3154
US

IV. Provider business mailing address

605 S CONROE MEDICAL DR
CONROE TX
77304-4722
US

V. Phone/Fax

Practice location:
  • Phone: 936-539-4004
  • Fax: 936-291-0746
Mailing address:
  • Phone: 936-539-4004
  • Fax: 936-539-3635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP131261
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: