Provider Demographics
NPI:1972544500
Name:SPINKS, DAVID WAYNE (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:SPINKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1904
Mailing Address - Country:US
Mailing Address - Phone:713-944-0189
Mailing Address - Fax:
Practice Address - Street 1:3350 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1904
Practice Address - Country:US
Practice Address - Phone:713-944-0189
Practice Address - Fax:713-944-6116
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115493201Medicaid
TX82981SOtherBC/BS PIN
TXB26612OtherUPIN
TX82981SOtherBC/BS PIN
TXB26612OtherUPIN