Provider Demographics
NPI:1871816710
Name:SPATES, NANCY ANNE
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANNE
Last Name:SPATES
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 1:1421 FM 359 RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2023
Mailing Address - Country:US
Mailing Address - Phone:281-232-1900
Mailing Address - Fax:
Practice Address - Street 1:1421 FM 359 RD
Practice Address - Street 2:SUITE H
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2023
Practice Address - Country:US
Practice Address - Phone:281-232-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-06
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist