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General NPI Number Information
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NPI Number | 1336322247
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Entity Type | Organization
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Legal Business Name | SPUR MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | RR 1 BOX 17 907 E. HILL ST
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City | SPUR
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State | TX
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Zip | 79370-9302
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Country | US
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Telephone | 806-271-3306
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Fax | 806-271-4256
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Provider Business Mailing Address
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Address Line | RR 1 BOX 17 907 E. HILL ST
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City | SPUR
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State | TX
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Zip | 79370-9302
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Country | US
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Telephone | 806-271-3306
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Fax | 806-271-4256
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GLENDA WHITE
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Credential |
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Telephone | 806-271-3306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | F3709
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License Number State | TX
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