Provider Demographics
NPI:1356329205
Name:SPOONER, ELIZABETH GOLLADAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:GOLLADAY
Last Name:SPOONER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:CAROL
Other - Last Name:GOLLADAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7121 S PADRE ISLAND DR STE 118
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-4946
Mailing Address - Country:US
Mailing Address - Phone:361-694-6054
Mailing Address - Fax:361-808-2718
Practice Address - Street 1:7121 S PADRE ISLAND DR STE 118
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4946
Practice Address - Country:US
Practice Address - Phone:361-694-6054
Practice Address - Fax:361-808-2718
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3595207VM0101X
OK31255207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX388371204Medicaid