Active NPI
Stephen C Spain
- Family Medicine Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- STEPHEN C SPAIN
- Practice address
- 5040 Kinsey Dr Ste 300
Tyler, TX 75703-3046 - Phone
- (903) 561-8300
- Fax
- (903) 561-8327
- NPI assigned
- Feb 20, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen C Spain, MD
- Title
- Owner
- Phone
- (903) 561-8300
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
5040 Kinsey Dr Ste 300
Tyler, TX 75703-3046
Mailing address
1702 Holly Creek Dr
Tyler, TX 75703-0907
Phone (903) 561-8300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010054743 | Other | RAILROAD MEDICARE | |
| 89X859 | Other | BLUE CROSS | |
| 133341103 | Medicaid | TX |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1107771 | Stephen C Spain MD | Certificate of waiver | Nov 11, 2027 |
National Provider Directory
National Provider DirectoryLocations
455 Rice Rd
Tyler, TX 75703
Phone (903) 509-4327
5040 Kinsey Dr
Ste 300
Tyler, TX 75703
Phone (903) 561-8300
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Tyler, TX
- NPI 1336662907
-
- Adult Health Nurse Practitioner
- Tyler, TX
- NPI 1902406309
-
- Adult Health Nurse Practitioner
- Tyler, TX
- NPI 1851814172
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787356800000",
"number": "1689718702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 HOLLY CREEK DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757030907",
"telephone_number": "903-561-8300",
"fax_number": "903-561-8327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5040 KINSEY DR STE 300",
"city": "TYLER",
"state": "TX",
"postal_code": "757033046",
"telephone_number": "903-561-8300",
"fax_number": "903-561-8327"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STEPHEN C SPAIN",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-20",
"last_updated": "2026-08-22",
"certification_date": "2026-08-22",
"status": "A",
"authorized_official_last_name": "SPAIN",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "903-561-8300",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "010054743",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "89X859",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133341103",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.