Healthcare Provider Details

I. General information

NPI: 1073618104
Provider Name (Legal Business Name): CHRIS ALAN SPARKMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 VISION PARK BLVD STE 110
SHENANDOAH TX
77384-3027
US

IV. Provider business mailing address

150 PINE FOREST DR STE 703
THE WOODLANDS TX
77384-5317
US

V. Phone/Fax

Practice location:
  • Phone: 936-224-4976
  • Fax: 832-995-5874
Mailing address:
  • Phone: 936-273-2016
  • Fax: 936-273-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberL5571
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL5571
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: