Provider Demographics
NPI:1851886881
Name:SPECHT, JENNIFER E (LM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:SPECHT
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5261 PRIVATE ROAD 5278
Mailing Address - Street 2:
Mailing Address - City:BAIRD
Mailing Address - State:TX
Mailing Address - Zip Code:79504-4245
Mailing Address - Country:US
Mailing Address - Phone:325-201-2945
Mailing Address - Fax:325-692-2345
Practice Address - Street 1:5261 PRIVATE ROAD 5278
Practice Address - Street 2:
Practice Address - City:BAIRD
Practice Address - State:TX
Practice Address - Zip Code:79504-4245
Practice Address - Country:US
Practice Address - Phone:325-201-2945
Practice Address - Fax:325-692-2345
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99339176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty