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General NPI Number Information
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NPI Number | 1093947434
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Entity Type | Organization
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Legal Business Name | TODD A SPENCER, MD, PA
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Dates
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Enumeration Date | 08/19/2009
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 11970 N CENTRAL EXPY STE 630
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City | DALLAS
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State | TX
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Zip | 75243-3793
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Country | US
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Telephone | 972-566-7188
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Fax | 972-566-2312
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Provider Business Mailing Address
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Address Line | PO BOX 269092
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-9092
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Country | US
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Telephone | 469-806-0777
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Fax | 469-694-8434
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | TANYA S GREEN
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Credential |
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Telephone | 469-806-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | L3839
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License Number State | TX
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