Provider Demographics
NPI:1063770055
Name:SPALLIN, DANIELLE MARIE (DO)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:SPALLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 LOWELL DR SE
Mailing Address - Street 2:STE 1
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3738
Mailing Address - Country:US
Mailing Address - Phone:973-535-3800
Mailing Address - Fax:
Practice Address - Street 1:1401 MEDICAL PARKWAY
Practice Address - Street 2:BLDG C SUITE 125
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-528-7385
Practice Address - Fax:512-528-7386
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2440207V00000X
TXU2329207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology