Spak, Cedric W.
Spak, Cedric W. is an individual health care provider with primary practice located at 1025 College Ave , Fort Worth TX 76104-3013. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Spak, Cedric W. can be contacted via phone (817) 810-9810.Contact Information
Primary practice address
1025 College Ave
Fort Worth TX 76104-3013
Phone: (817) 810-9810
Fax: (817) 840-9815
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | MD00043412 | Washington |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | L1206 | Texas |
Profile Details
| NPI number | 1063575199 |
|---|---|
| LBN Legal business name | Spak, Cedric W. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Oct 29th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063575199 | NPPES |
| Texas | Other | 8J4777 | MEDICARE |
| Texas | MEDICAID | 145478703 | MEDICARE |
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