Provider Demographics
NPI:1144489758
Name:SPEARS, MARK T (MS CCC A)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:T
Last Name:SPEARS
Suffix:
Gender:M
Credentials:MS CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 N GEORGE BUSH
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2210
Mailing Address - Country:US
Mailing Address - Phone:972-675-1606
Mailing Address - Fax:
Practice Address - Street 1:7150 N GEORGE BUSH
Practice Address - Street 2:SUITE 200
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2210
Practice Address - Country:US
Practice Address - Phone:972-675-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50518231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist