# TODD A SPENCER, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TODD A SPENCER,MD, PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093947434
- **Legal business name:** TODD A SPENCER,MD, PA
- **Authorized official:** TANYA S GREEN (PRACTICE MANAGER)
- **Authorized official phone:** (469) 806-0777

## Contact information

- **Practice address:** 11970 N CENTRAL EXPY STE 630, DALLAS, TX 75243-3793
- **Practice address phone:** (972) 566-7188
- **Practice address fax:** (972) 566-2312
- **Mailing address:** PO BOX 269092, OKLAHOMA CITY, OK 73126-9092
- **Mailing address phone:** (469) 806-0777
- **Mailing address fax:** (469) 694-8434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | L3839 | TX | Yes |

## Other

- **Enumeration date:** 08/19/2009
- **Last updated:** 12/31/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0038TA | BCBS | TX |
| 05 | — | 157541702 | — | TX |