Provider Demographics
NPI:1548670177
Name:SPICER, PATRICK PAUL (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:PAUL
Last Name:SPICER
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 1:2990 LEGACY DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6066
Mailing Address - Country:US
Mailing Address - Phone:469-888-5156
Mailing Address - Fax:717-547-8607
Practice Address - Street 1:2990 LEGACY DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6066
Practice Address - Country:US
Practice Address - Phone:469-888-5156
Practice Address - Fax:717-547-8607
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP20054894390200000X
TXR6682208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program