Individual
DR. BRENT AUSTIN SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3535 VICTORY GROUP WAY, STE 200, FRISCO, TX 75034-6721
(972) 712-5100
(972) 712-5113
Mailing address
3535 VICTORY GROUP WAY, STE 200, FRISCO, TX 75034-6721
(972) 712-5100
(972) 712-5113
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
M8356
TX
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
M8356
TX
207NS0135X
Procedural Dermatology Physician
M8356
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8CC921
BCBSTX INDIVIDUAL ID
TX
Enumeration date
05/27/2008
Last updated
10/19/2020
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