Spackman, Gregory Keith

Spackman, Gregory Keith is an individual health care provider with primary practice located at 7703 Floyd Curl Dr , San Antonio TX 78229-3901. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Spackman, Gregory Keith can be contacted via phone (210) 567-3477.

Contact Information

Primary practice address
7703 Floyd Curl Dr San Antonio TX 78229-3901
Phone: (210) 567-3477
Fax: (210) 567-3493
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 17454 Texas

Profile Details

NPI number 1790785061
LBN Legal business name Spackman, Gregory Keith
Credentials DDS MBA
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Jan 28th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790785061 NPPES
Texas MEDICAID 126785803
Texas Other 126780805

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