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General NPI Number Information
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NPI Number | 1356157655
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Entity Type | Organization
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Legal Business Name | GARY W SPANGLER JR MD
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 4910 COUNTY ROAD 182
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City | ALVIN
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State | TX
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Zip | 77511-9361
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Country | US
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Telephone | 832-385-4835
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 COUNTY ROAD 182
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City | ALVIN
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State | TX
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Zip | 77511-9361
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. GARY W SPANGLER
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Credential | MD
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Telephone | 832-385-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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