Healthcare Provider Details
I. General information
NPI: 1851608319
Provider Name (Legal Business Name): DAVID W SPINKS DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/06/2010
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3350 FAIRVIEW ST
PASADENA TX
77504-1904
US
IV. Provider business mailing address
3350 FAIRVIEW ST
PASADENA TX
77504-1904
US
V. Phone/Fax
- Phone: 713-944-0189
- Fax: 713-944-6116
- Phone: 713-944-0189
- Fax: 713-944-6116
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | F4557 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
DAVID
W
SPINKS
Title or Position: DOCTOR/OWNER
Credential: D.O.
Phone: 713-944-0189