Provider Demographics
NPI:1295849693
Name:TED D SPEARS, MD, PA
Entity Type:Organization
Organization Name:TED D SPEARS, MD, PA
Other - Org Name:SPORTS PERFORMANCE INTERNATIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-708-8834
Mailing Address - Street 1:9737 GREAT HILLS TRL STE 240
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-6418
Mailing Address - Country:US
Mailing Address - Phone:512-708-8834
Mailing Address - Fax:
Practice Address - Street 1:9737 GREAT HILLS TRL STE 240
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-6418
Practice Address - Country:US
Practice Address - Phone:512-708-8834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7190207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty