Provider Demographics
NPI:1578543021
Name:SPADACCINI, CATHY J (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:J
Last Name:SPADACCINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9600 DATAPOINT DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2028
Mailing Address - Country:US
Mailing Address - Phone:210-912-3684
Mailing Address - Fax:210-617-4692
Practice Address - Street 1:9600 DATAPOINT DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2028
Practice Address - Country:US
Practice Address - Phone:210-912-3684
Practice Address - Fax:210-617-4692
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8682207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124811401Medicaid
TXB26590Medicare UPIN
TX83P822Medicare ID - Type Unspecified