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General NPI Number Information
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NPI Number | 1881564672
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Entity Type | Organization
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Legal Business Name | SPOGO LLC
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1400 W NORTHWEST HWY SUITE #240
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City | GRAPEVINE
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State | TX
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Zip | 76051
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Country | US
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Telephone | 214-471-4556
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 N AKARD ST # 220
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City | DALLAS
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State | TX
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Zip | 75201-2301
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Country | US
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Telephone | 214-471-4556
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MICHELLE A RANKINE
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Credential |
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Telephone | 214-471-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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