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Organization

BRIAN SPORE DO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN SPORE (DO)
(936) 634-2231
Entity
Organization

Contact information

Practice address
3804 S MEDFORD DR, LUFKIN, TX 75901-5780
(936) 634-2231
(936) 634-8012
Mailing address
3804 S MEDFORD DR, LUFKIN, TX 75901-5780
(936) 634-2231
(936) 634-8012

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
K5703
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
092514101
TX
Enumeration date
04/29/2011
Last updated
04/29/2011
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