Provider Demographics
NPI:1184833592
Name:SPENCER, BELINDA LEE (-)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:LEE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 WHEATON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234-2607
Mailing Address - Country:US
Mailing Address - Phone:210-221-6017
Mailing Address - Fax:210-221-7850
Practice Address - Street 1:2050 WORTH RD
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-7533
Practice Address - Country:US
Practice Address - Phone:210-221-6017
Practice Address - Fax:210-221-7850
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX587349163WC0200X
TX363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Not Answered363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care