Provider Demographics
NPI:1518910223
Name:SPENCER, NALI (MD)
Entity Type:Individual
Prefix:
First Name:NALI
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 SAN FELIPE ST APT 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2730
Mailing Address - Country:US
Mailing Address - Phone:713-972-8900
Mailing Address - Fax:713-972-8925
Practice Address - Street 1:6363 SAN FELIPE ST APT 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2730
Practice Address - Country:US
Practice Address - Phone:713-972-8900
Practice Address - Fax:713-972-8925
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9672207R00000X, 208M00000X
IA35307207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0429795Medicaid
IA7709720Medicaid
IA18359OtherWELLMARK BCBS IA
IA421283849-46Medicaid
I02610Medicare UPIN
IA421283849-46Medicaid