MEDICARE: DR. JAYCILE LITTLE SPEARS 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
1	174400000X	Specialist	G3808	TX

General Provider Information

NPI Number	:	1881789626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAYCILE LITTLE SPEARS M.D.

Provider Business Mailing Address
First Line	:	6204 MEADOW
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-5139
Country	:	US
Telephone Number	:	214-363-4481
Fax Number	:	214-363-4483

Provider Business Practice Location Address
First Line	:	6204 MEADOW
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-5139
Country	:	US
Telephone Number	:	214-363-4481
Fax Number	:	214-363-4483

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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