Provider Demographics
NPI:1356452692
Name:SPURLOCK, WILLIAM MARCUS (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MARCUS
Last Name:SPURLOCK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9535 FOREST LN
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6169
Mailing Address - Country:US
Mailing Address - Phone:214-389-1234
Mailing Address - Fax:214-389-1230
Practice Address - Street 1:12740 HILLCREST RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2038
Practice Address - Country:US
Practice Address - Phone:972-980-2300
Practice Address - Fax:972-980-3730
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-04-01
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Provider Licenses
StateLicense IDTaxonomies
TXJ7209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119330204Medicaid
TX119330204Medicaid
TX8B3115Medicare ID - Type Unspecified