Provider Demographics
NPI:1740501972
Name:SPINDLE, JORDAN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:DAVID
Last Name:SPINDLE
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 1:3415 GOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8355
Mailing Address - Country:US
Mailing Address - Phone:903-526-0444
Mailing Address - Fax:
Practice Address - Street 1:3415 GOLDEN RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8355
Practice Address - Country:US
Practice Address - Phone:903-526-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10037233207W00000X, 207W00000X
AL33130207WX0200X
TXQ8647207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ8647OtherTEXAS MEDICAL BOARD LICENSE