Provider Demographics
NPI:1174503163
Name:SPAW, RAYMOND GEBHART (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:GEBHART
Last Name:SPAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1219
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-7219
Mailing Address - Country:US
Mailing Address - Phone:830-693-2600
Mailing Address - Fax:830-693-9755
Practice Address - Street 1:1205 CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:LAMPASAS
Practice Address - State:TX
Practice Address - Zip Code:76550-3388
Practice Address - Country:US
Practice Address - Phone:512-556-5362
Practice Address - Fax:512-556-8004
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1452207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB119964Medicare PIN