MEDICARE: JON SPENCER FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	1123746	TX
2	363LF0000X	Family Nurse Practitioner	1123746	TX

General Provider Information

NPI Number	:	1437842085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON SPENCER FNP-C

Provider Business Mailing Address
First Line	:	1101 GROVE BLVD APT 605
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-3507
Country	:	US
Telephone Number	:	806-577-1362
Fax Number	:

Provider Business Practice Location Address
First Line	:	2406 HUNTER RD STE 106
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5256
Country	:	US
Telephone Number	:	512-396-7686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2023
Last Update Date	:	04/07/2025

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Directions to “ JON SPENCER FNP-C” Practice Location

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