Provider Demographics
NPI:1356467120
Name:SPRING FAMILY PRACTICE ASSOCIATES PA
Entity Type:Organization
Organization Name:SPRING FAMILY PRACTICE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAYAKAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOPARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-257-5977
Mailing Address - Street 1:6225 FM 2920
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3424
Mailing Address - Country:US
Mailing Address - Phone:281-257-5977
Mailing Address - Fax:281-257-5966
Practice Address - Street 1:6225 FM 2920
Practice Address - Street 2:SUITE100
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3424
Practice Address - Country:US
Practice Address - Phone:281-257-5977
Practice Address - Fax:281-257-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6740207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z271Medicare PIN