Provider Demographics
NPI:1699169623
Name:SPENCER, EMILY L (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:L
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:L
Other - Last Name:GRUETZMACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6431 FANNIN STREET
Mailing Address - Street 2:MSB 3.286
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3004
Mailing Address - Country:US
Mailing Address - Phone:713-500-6412
Mailing Address - Fax:713-500-7860
Practice Address - Street 1:6410 FANNIN ST STE 350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3004
Practice Address - Country:US
Practice Address - Phone:832-325-7200
Practice Address - Fax:713-512-2237
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09825363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8031NROtherBCBS
TX346458801Medicaid