Provider Demographics
NPI:1740774785
Name:SPENCER, GRACE SCHULER (PSYD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:SCHULER
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2419 W SOUTHLAKE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1506
Mailing Address - Country:US
Mailing Address - Phone:817-601-5540
Mailing Address - Fax:
Practice Address - Street 1:2419 W SOUTHLAKE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-1506
Practice Address - Country:US
Practice Address - Phone:817-601-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2025-05-17
Deactivation Date:2020-05-26
Deactivation Code:
Reactivation Date:2025-05-13
Provider Licenses
StateLicense IDTaxonomies
TX39800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist