Provider Demographics
NPI:1982292983
Name:SPANJOL, VERONICA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:MARIE
Last Name:SPANJOL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 SPECTRUM BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-9705
Mailing Address - Country:US
Mailing Address - Phone:972-478-0322
Mailing Address - Fax:972-907-1182
Practice Address - Street 1:3417 SPECTRUM BLVD STE 200
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-9705
Practice Address - Country:US
Practice Address - Phone:972-478-0322
Practice Address - Fax:972-907-1187
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX882577163WP0808X
TX1024855363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty