Provider Information for 1003959511
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CHARLES NOLAN SPIVEY LPC
Sex: Male
NPI: 1003959511
Last Updated: 2023-11-20
Certification Date: 2023-11-20
Certification Date: 2023-11-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1003959511 | ||||||||
| Enumeration Date | 2007-02-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6800 PARK TEN BLVD STE 200S SAN ANTONIO, TX 78213-4293 United States Phone: 210-261-1000 | Fax:210-261-1821 | ||||||||
| Primary Practice Address | 315 N SAN SABA STE 1003 SAN ANTONIO, TX 78207-3100 United States Phone: 210-261-3100 | Fax:210-261-3742 | ||||||||
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