| Stephen C Spain | |
|
455 Rice Rd Tyler TX 75703 | |
| (903) 534-0911 | |
| Not Available |
| Full Name | Stephen C Spain |
|---|---|
| Speciality | Family Medicine |
| Location | 455 Rice Rd, Tyler, Texas |
| Authorized Official Name and Position | Stephen C Spain (OWNER) |
| Authorized Official Contact | 9035340911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen C Spain 1702 Holly Creek Dr Tyler TX 75703-0907 Ph: (903) 543-0911 | Stephen C Spain 455 Rice Rd Tyler TX 75703 Ph: (903) 534-0911 |
| NPI Number | 1689718702 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 01/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689718702 | NPI | - | NPPES |
| 89X859 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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