Provider Demographics
NPI:1831295682
Name:SPINKS, RICKY DEAN
Entity Type:Individual
Prefix:
First Name:RICKY
Middle Name:DEAN
Last Name:SPINKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 68TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-6310
Mailing Address - Country:US
Mailing Address - Phone:806-445-0491
Mailing Address - Fax:806-785-2094
Practice Address - Street 1:2738 68TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-6310
Practice Address - Country:US
Practice Address - Phone:806-445-0491
Practice Address - Fax:806-785-2094
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00189246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N4261OtherBLUE CROSS