Provider Demographics
NPI:1780821579
Name:CHRISTMAS SPENCER, SUBAIR
Entity Type:Individual
Prefix:
First Name:SUBAIR
Middle Name:
Last Name:CHRISTMAS SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUBAIR
Other - Middle Name:
Other - Last Name:CHRISTMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:139 TAMANDA LN
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:77541-9338
Mailing Address - Country:US
Mailing Address - Phone:979-709-2918
Mailing Address - Fax:
Practice Address - Street 1:139 TAMANDA LN
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:TX
Practice Address - Zip Code:77541-9338
Practice Address - Country:US
Practice Address - Phone:979-709-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor