Individual
TINA MARIE SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
1108A E MULBERRY ST, ANGLETON, TX 77515-3907
(979) 849-9740
Mailing address
301 UNIVERSITY BLVD, PROVIDER ENROLLMENT -- RT 1022, GALVESTON, TX 77555-5302
(409) 747-0890
(409) 772-0885
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
584615
TX
Other
Enumeration date
08/09/2007
Last updated
08/09/2007
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