Individual
MICHAEL GREGORY SPANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J0275
TX
207LP3000X
Pediatric Anesthesiology Physician
J0275
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067240A
—
OK
05
—
126526612
—
TX
01
—
8EH510
BCBS
TX
01
—
P014466772
RR
TX
Enumeration date
12/20/2006
Last updated
07/02/2018
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