DR. CHARLA C SPENCER (NPI# 1700851193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700851193 |
| Entity Type | Individual |
| Full Name | DR. CHARLA C SPENCER |
| Credential | MD |
| Practice Address |
1720 S Beckham Ave Ste 104 Tyler TX 75701-4464 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9035972002 |
| Mailing Telephone | (903) 324-6450 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2017-08-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | L0615 | TX | Allopathic & Osteopathic Physicians |
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
L0615 | TX | Allopathic & Osteopathic Physicians |
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
L0615 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 039151804 | 05 | |
| TX | 039151805 | 05 | |
| TX | SUPERIOR CHIPS | 123894 | 01 |
| TX | TRICARE | 75-2616977-136 | 01 |
| TX | TRICARE | 752616977026 | 01 |
| TX | RAIL ROAD MEDICARE | P01572867 | 01 |
| TX | BCBS | 8FL328 | 01 |
| TX | 039151802 | 05 | |
| TX | BCBS OF TEXAS | 8A0740 | 01 |
| TX | 039151801 | 05 | |
| TX | AETNA | 7600108 | 01 |
| TX | TRICARE | 45-2578435-002 | 01 |
| Street Address |
1720 S BECKHAM AVE STE 104 |
| City | TYLER |
| State | TX |
| Zip Code | 75701-4464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710950530 | Stephanie H Carl | Obstetrics & Gynecology | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2006-02-10 |
| 1174183693 | Shelly Bailey | Nurse Practitioner | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4437 | 2019-06-17 |
| 1518291988 | Amy A Bundy | Nurse Practitioner | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2009-10-01 |
| 1891939088 | Misty Dawn Herod | Obstetrics & Gynecology | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2009-05-01 |
| 1366497992 | Jennifer Rippy | Nurse Practitioner | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2006-05-23 |
| 1417923111 | Daren Patrick Yeager | Obstetrics & Gynecology | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2006-02-23 |
| 1164496907 | William W Miller | Obstetrics & Gynecology | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2006-02-16 |
| 1972577419 | Paul M Fanning | Obstetrics & Gynecology | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407229693 | Ann H Abrameit | Obstetrics & Gynecology | 1100 E Lake St Ste 260, Tyler, TX 75701-3359 | 2015-11-10 |
| 1093009185 | Jessica Clifton Charest | Obstetrics & Gynecology | 700 Olympic Plaza Cir Ste 602, Tyler, TX 75701 | 2011-06-06 |
| 1184952392 | Womens Environment | Obstetrics & Gynecology | 619 Courtview, Tyler, TX 75703-5916 | 2009-11-28 |
| 1316001753 | Sherilyn A. Willis | Obstetrics & Gynecology | 2017 Rickety Ln, Tyler, TX 75703-1706 | 2006-12-20 |
| 1346250149 | William E Brown | Obstetrics & Gynecology | 4290 Kinsey Dr, Ste 200, Tyler, TX 75703-1024 | 2006-08-08 |
| 1336159128 | Amanda L Harris | Obstetrics & Gynecology | 700 Olympic Plaza Cir Ste 503, Tyler, TX 75701-1952 | 2006-08-08 |
| 1528096542 | Arnold D Wharton | Obstetrics & Gynecology | 900 Medical Dr, Tyler, TX 75701-2129 | 2006-06-29 |
| 1740230820 | Trinity Clinic | Obstetrics & Gynecology | 733 S. Fleishel, Tyler, TX 75701 | 2006-05-11 |
| 1568435329 | Joe B Belue | Obstetrics & Gynecology | 534 S Beckham Ave, Tyler, TX 75702-8310 | 2006-02-10 |
| 1710950530 | Stephanie H Carl | Obstetrics & Gynecology | 1720 S Beckham Ave Ste 104, Tyler, TX 75701-4464 | 2006-02-10 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.