Provider Demographics
NPI:1871070136
Name:SPINUZZA, JAMES ROBERT (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:SPINUZZA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 LOOP 150 W
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-3930
Mailing Address - Country:US
Mailing Address - Phone:512-321-2106
Mailing Address - Fax:
Practice Address - Street 1:87 LOOP 150 W
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-3930
Practice Address - Country:US
Practice Address - Phone:512-321-2106
Practice Address - Fax:512-322-0273
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003100152W00000X
TX9876TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist