Provider Demographics
NPI:1730572066
Name:SPIRES, PORSCHE
Entity type:Individual
Prefix:
First Name:PORSCHE
Middle Name:
Last Name:SPIRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PORSCHE
Other - Middle Name:
Other - Last Name:HANNAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:6220 TEXANA WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-2075
Mailing Address - Country:US
Mailing Address - Phone:214-650-9963
Mailing Address - Fax:
Practice Address - Street 1:6220 TEXANA WAY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:214-650-9963
Practice Address - Fax:214-650-9963
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116779225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist