Provider Demographics
NPI:1104038025
Name:SPRAGINS, BETH (OD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:SPRAGINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MELLIE
Other - Middle Name:ELIZABETH
Other - Last Name:BRATCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:24200 SOUTHWEST FWY STE 102
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5985
Practice Address - Country:US
Practice Address - Phone:703-847-8899
Practice Address - Fax:571-223-6780
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6107TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist