Provider Demographics
NPI:1396786794
Name:OBIE, SPENCER U (OD)
Entity type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:U
Last Name:OBIE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MCKINNEY ST STE 411
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77010-2038
Mailing Address - Country:US
Mailing Address - Phone:713-759-9449
Mailing Address - Fax:713-759-6915
Practice Address - Street 1:1200 MCKINNEY ST STE 411
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77010-2038
Practice Address - Country:US
Practice Address - Phone:713-759-9449
Practice Address - Fax:713-759-6915
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6814TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188467802Medicaid
TX188467801Medicaid