Healthcare Provider Details

I. General information

NPI: 1295156925
Provider Name (Legal Business Name): SPINKS HOME VISITS MHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2013
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6842 CEDAR LAWN CIR
PASADENA TX
77505-4304
US

IV. Provider business mailing address

1515 HERITAGE DR STE 110
MCKINNEY TX
75069-3379
US

V. Phone/Fax

Practice location:
  • Phone: 713-944-0189
  • Fax: 713-944-6116
Mailing address:
  • Phone: 855-860-2109
  • Fax: 855-814-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JUDY POSTLE
Title or Position: CREDENTIALIST
Credential:
Phone: 469-744-0237