Provider Demographics
NPI:1104407006
Name:SPRUNGER, ABIGAIL ELLEN
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ELLEN
Last Name:SPRUNGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ELLEN
Other - Last Name:SCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 7TH AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4396
Mailing Address - Country:US
Mailing Address - Phone:210-705-2400
Mailing Address - Fax:
Practice Address - Street 1:1401 ST JOSEPH PKWY # 1106A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8301
Practice Address - Country:US
Practice Address - Phone:713-756-8374
Practice Address - Fax:713-657-7191
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program