Provider Demographics
NPI:1851145833
Name:SPENCER, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 CITY PARK CENTRAL LN APT 5207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-3751
Mailing Address - Country:US
Mailing Address - Phone:346-221-3414
Mailing Address - Fax:
Practice Address - Street 1:11900 CITY PARK CENTRAL LN APT 5207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-3751
Practice Address - Country:US
Practice Address - Phone:346-221-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program