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NPI Code Detail

MEDICARE: DR. DAVID K SPADY M.D.

MEDICARE: DR. DAVID K SPADY M.D.
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
1207RG0100XGastroenterology PhysicianF8683TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18004K2OTHERTXBCBS

General Provider Information

NPI Number : 1639155005
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID K SPADY M.D.
Provider Business Mailing Address
First Line : PO BOX 35629
Second Line :
City : DALLAS
State : TX
Zip : 75235-0629
Country : US
Telephone Number : 214-424-2213
Fax Number : 214-231-2159
Provider Business Practice Location Address
First Line : 505 S NOLEN DR
Second Line :
City : SOUTHLAKE
State : TX
Zip : 76092-9167
Country : US
Telephone Number : 817-424-1525
Fax Number : 817-424-3491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 05/16/2013

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Directions to “ DR. DAVID K SPADY M.D.” Practice Location

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