Provider Demographics
NPI:1679709893
Name:SPRYS, MICHAEL JEROME (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JEROME
Last Name:SPRYS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-2438
Mailing Address - Country:US
Mailing Address - Phone:806-796-0507
Mailing Address - Fax:806-799-6908
Practice Address - Street 1:2200 N BRYAN AVE
Practice Address - Street 2:
Practice Address - City:LAMESA
Practice Address - State:TX
Practice Address - Zip Code:79331-2451
Practice Address - Country:US
Practice Address - Phone:806-872-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7881207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM