Provider Demographics
NPI:1467668921
Name:SPEIR, ELWYN DUANE (DDS)
Entity Type:Individual
Prefix:
First Name:ELWYN
Middle Name:DUANE
Last Name:SPEIR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2532
Mailing Address - Country:US
Mailing Address - Phone:512-453-5843
Mailing Address - Fax:512-453-5963
Practice Address - Street 1:2219 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2532
Practice Address - Country:US
Practice Address - Phone:512-453-5843
Practice Address - Fax:512-453-5963
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice