Healthcare Provider Details

I. General information

NPI: 1780699140
Provider Name (Legal Business Name): JIM B SPEARS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 05/20/2024
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 HILLCREST DR
VERNON TX
76384-4099
US

IV. Provider business mailing address

1720 HILLCREST DR
VERNON TX
76384-4099
US

V. Phone/Fax

Practice location:
  • Phone: 940-552-2999
  • Fax: 940-552-5347
Mailing address:
  • Phone: 940-552-2999
  • Fax: 940-552-5347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number16832
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number16832
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number16832
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number16832
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number16832
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number16832
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number16832
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number16832
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number16832
License Number StateTX
# 10
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number16832
License Number StateTX
# 11
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: TERRY J SPEARS
Title or Position: PRESIDENT
Credential:
Phone: 940-552-2999