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Individual
MR. PHILLIP BRIAN SPENCER
Active
Individual
MR. PHILLIP BRIAN SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSCCC/SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
101754
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175217201
—
TX
01
—
8T4286;8T4074
BCBS
TX
Enumeration date
08/05/2006
Last updated
04/20/2010
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