Individual
JEFFREY N SPAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1451 GREENS PRAIRIE RD W STE 200, COLLEGE STATION, TX 77845
(979) 999-1838
(877) 793-6195
Mailing address
1451 GREENS PRAIRIE RD W STE 200, COLLEGE STATION, TX 77845-8794
(979) 999-1838
(877) 793-6195
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
J6735
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E697
MEDICARE GROUP
TX
01
—
137248402
MEDICAID GROUP
TX
05
—
138555114
—
TX
05
—
138555115
—
TX
01
—
8AA855
BLUE CROSS
TX
01
—
8H9135
BCBS
TX
01
—
CL0719
MEDICARE LAB
TX
01
—
P00369919
RR
TX
Enumeration date
05/06/2006
Last updated
06/11/2019
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