Provider Demographics
NPI:1811392533
Name:SPEIGHT, TOBY MICHAEL (AGACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:TOBY
Middle Name:MICHAEL
Last Name:SPEIGHT
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE C-300J
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2571
Mailing Address - Country:US
Mailing Address - Phone:972-566-7050
Mailing Address - Fax:972-566-7097
Practice Address - Street 1:7777 FOREST LN STE C-300J
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-7050
Practice Address - Fax:972-566-7097
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126660363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner