| Doctor Name: | TINA MARIE SPENCER |
| NPI Number: | 1366633760 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHCNP |
| License Number: | 584615 |
| Business Practice Address: | 1108a E Mulberry St Angleton, TX - 775153907 |
| Business Phone Number: | 9798499740 |
| Business Fax Number: | |
| Mailing Address: | 301 University Blvd, Provider Enrollment -- Rt 1022 GALVESTON |
| State: | TX |
| Postal Code: | 775555302 |
| Phone Number: | 4097470890 |
| Fax Number: | 4097720885 |
| NPI Enumeration Date: | 08/09/2007 |
| NPI Last Update Date: | 08/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 584615 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |