Tavon Lamar Spears, ATC
Specialist/Technologist, Athletic Trainer in Desoto, TX. Individual provider (NPI-1).
NPI number1245976166
StatusActive
Last updated in NPPESMay 12, 2022
Details
- NPI
- 1245976166
- Entity type
- Individual (NPI-1)
- Name
- Mr. Tavon Lamar Spears
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 12, 2022
- Certification date
- May 12, 2022
- Last updated
- May 12, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2000050677 | TX | Yes |
Practice location
1501 Tanglerose CtDesoto, TX 75115-7843
Phone 469-765-7119
Mailing address
1501 Tanglerose CtDesoto, TX 75115-7843
Phone 469-765-7119
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All 9 Athletic Trainer providers in Desoto · All 1,362 providers in Desoto
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