Provider Demographics
NPI:1306828082
Name:SPINNATO, RICHARD JASPER (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JASPER
Last Name:SPINNATO
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 1:350 KINGWOOD MEDICAL DRIVE
Mailing Address - Street 2:#300
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-359-7000
Mailing Address - Fax:281-359-5833
Practice Address - Street 1:350 KINGWOOD MEDICAL DRIVE
Practice Address - Street 2:#300
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-359-7000
Practice Address - Fax:281-359-5833
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5071207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1140493Medicaid
TX1140493Medicaid
E76995Medicare UPIN