Provider Demographics
NPI:1134161367
Name:SPENCER, STEVEN C (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:SPENCER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S FRY RD STE 115
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2243
Mailing Address - Country:US
Mailing Address - Phone:281-398-4222
Mailing Address - Fax:281-398-4001
Practice Address - Street 1:701 S FRY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2255
Practice Address - Country:US
Practice Address - Phone:281-398-4222
Practice Address - Fax:281-398-4001
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R1610OtherBLUE CROSS BLUE SHIELD
TX4116740OtherAETNA
TX8R1610OtherBLUE CROSS BLUE SHIELD
TX4116740OtherAETNA