Basic Information
| Provider Information | |||||||||
| NPI: | 1548645047 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPARKMAN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | JO | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 146 COUNTY ROAD 2732 | ||||||||
| Address2: | |||||||||
| City: | MICO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780565339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8303333490 | ||||||||
| FaxNumber: | 2109735737 | ||||||||
| Practice Location | |||||||||
| Address1: | SABINAL HEALTH CLINIC | ||||||||
| Address2: | 517 N. CENTER ST. | ||||||||
| City: | SABINAL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8309882582 | ||||||||
| FaxNumber: | 8309882580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2015 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP128615 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.