Provider Demographics
NPI:1962787382
Name:SPRADLIN, DAVID (HIS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SPRADLIN
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 BROWN TRL
Mailing Address - Street 2:SUITE Q
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4135
Mailing Address - Country:US
Mailing Address - Phone:817-656-8600
Mailing Address - Fax:817-656-8602
Practice Address - Street 1:2905 BROWN TRL
Practice Address - Street 2:SUITE Q
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4135
Practice Address - Country:US
Practice Address - Phone:817-656-8600
Practice Address - Fax:817-656-8602
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80366237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist