=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356226567
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRECISION LONGEVITY AND FAMILY MEDICINE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2025
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5512 114TH ST
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79424-2177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-575-7298
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5512 114TH ST
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79424-2177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-288-1075
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSICIAN
-----------------------------------------------------
Name | DR. MICHAEL JEROME SPRYS
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 979-575-7298
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------