Individual
SHAWN JENSE SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
BP10054003
TX
2084P0800X
Psychiatry Physician
Primary
R0659
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366072201
—
TX
Enumeration date
05/26/2015
Last updated
04/18/2017
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