Provider Demographics
NPI:1922448174
Name:SPIERS, MANDY M (FNP)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:M
Last Name:SPIERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843204
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-3204
Mailing Address - Country:US
Mailing Address - Phone:956-630-4161
Mailing Address - Fax:956-664-1398
Practice Address - Street 1:416 LINDBERG AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2922
Practice Address - Country:US
Practice Address - Phone:956-630-4161
Practice Address - Fax:956-664-1398
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3272858-01Medicaid
TX317856YKSJMedicare PIN