Brian Spore Do Pa

LBN: Brian Spore Do Pa
Brian Spore Do Pa is an health care organization with primary practice located at 3804 S Medford Dr , Lufkin TX 75901-5780. The organization recently has only one registered license in Managed Care Organizations / Point of Service, which is considered as the primary health care specialty. Brian Spore Do Pa can be contacted via phone (936) 634-2231, or through Spore, Brian via phone (936) 634-2231.

Contact Information

Primary practice address
3804 S Medford Dr Lufkin TX 75901-5780
Phone: (936) 634-2231
Fax: (936) 634-8012
Website:
Map and Directions
Authorized official contact:
Name: Spore, Brian
Phone: (936) 634-2231

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Point of Service 305S00000X K5703 Texas

Profile Details

NPI number 1114218708
LBN Legal business name Brian Spore Do Pa
DBA Doing business as
Authorized official Spore, Brian
Entity Organization
Organization subpart 1 No
Enumeration date Apr 29th, 2011
Last updated Apr 29th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114218708 NPPES
Texas MEDICAID 092514101

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