Healthcare Provider Details

I. General information

NPI: 1356467120
Provider Name (Legal Business Name): SPRING FAMILY PRACTICE ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 12/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 FM 2920 SUITE100
SPRING TX
77379-3424
US

IV. Provider business mailing address

6225 FM 2920 SUITE 100
SPRING TX
77379-3424
US

V. Phone/Fax

Practice location:
  • Phone: 281-257-5977
  • Fax: 281-257-5966
Mailing address:
  • Phone: 281-257-5977
  • Fax: 281-257-5966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberL6740
License Number StateTX

VIII. Authorized Official

Name: MR. DAYAKAR R MOPARTY
Title or Position: BILLING MANAGER
Credential:
Phone: 281-257-5977