Provider Demographics
NPI:1316347115
Name:SPIGENR, TAMIZA
Entity type:Individual
Prefix:MS
First Name:TAMIZA
Middle Name:
Last Name:SPIGENR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 BRECKENRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-1707
Mailing Address - Country:US
Mailing Address - Phone:903-952-5065
Mailing Address - Fax:
Practice Address - Street 1:2414 BRECKENRIDGE ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-1707
Practice Address - Country:US
Practice Address - Phone:903-952-5065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management