Provider Demographics
NPI:1285676437
Name:SPIVEY, MICHAEL RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RAY
Last Name:SPIVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:3720 S I-35 E
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6857
Practice Address - Country:US
Practice Address - Phone:940-382-1022
Practice Address - Fax:940-380-7904
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2032207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047606103Medicaid
TX045811901Medicaid
TX8R1556OtherBLUE CROSS OF TEXAS
TX47616102Medicaid
TX8807J7Medicare PIN
TX8R1556OtherBLUE CROSS OF TEXAS
TX047606103Medicaid
TX830006511Medicare PIN