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General NPI Number Information
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NPI Number | 1952343857
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Entity Type | Individual
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Provider Name | TODD A SPENCER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 7777 FOREST LN SUITE C516
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 972-566-7188
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Fax | 972-566-2312
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Provider Business Mailing Address
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Address Line | PO BOX 269092
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-9092
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Country | US
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Telephone | 972-566-7188
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Fax | 972-566-2312
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | L3839
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License Number State | TX
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