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Individual
STEPHEN C SPAIN
Active
Individual
STEPHEN C SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G0154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010054743
RAILROAD MEDICARE
TX
05
—
133341103
—
TX
01
—
89X859
BLUE CROSS
TX
Enumeration date
07/07/2006
Last updated
11/20/2009
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