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General NPI Number Information
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NPI Number | 1821171166
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Entity Type | Individual
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Provider Name | KEITH I.G. SPOONER MD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 117 S WILLIAM BARNETT AVE SUITE A
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City | CLEVELAND
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State | TX
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Zip | 77327-4542
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Country | US
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Telephone | 281-593-1660
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Fax | 281-593-0730
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Provider Business Mailing Address
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Address Line | 108 S WILLIAM BARNETT AVE SUITE A
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City | CLEVELAND
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State | TX
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Zip | 77327-4542
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Country | US
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Telephone | 281-659-2355
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Fax | 281-592-1570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G2229
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License Number State | TX
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