| Ivan C Spector Md Pa | |
|
3100 Weslayan St #350 Houston TX 77027-5727 | |
| (713) 963-0769 | |
| (713) 963-8536 |
| Full Name | Ivan C Spector Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3100 Weslayan St, Houston, Texas |
| Authorized Official Name and Position | Ivan C Spector (PRESIDENT) |
| Authorized Official Contact | 7139630769 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivan C Spector Md Pa 3100 Weslayan St #350 Houston TX 77027-5727 Ph: (713) 963-0769 | Ivan C Spector Md Pa 3100 Weslayan St #350 Houston TX 77027-5727 Ph: (713) 963-0769 |
| NPI Number | 1801961818 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 06/07/2012 |
| Medicare PECOS PAC ID | 1052574399 |
|---|---|
| Medicare Enrollment ID | O20120523000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801961818 | NPI | - | NPPES |
| 00F89F | Other | TX | BCBS |
| 122926202 | Medicaid | TX | |
| 00F89F | Other | TX | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G5633 (Texas) | Primary |
| Provider Name | Ivan C Spector |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124207279 PECOS PAC ID: 8921262627 Enrollment ID: I20120608000330 |
| Provider Name | Thomas L Hambleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003383985 PECOS PAC ID: 8426390626 Enrollment ID: I20190508000190 |
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