Provider Demographics
NPI:1881564672
Name:SPOGO LLC
Entity type:Organization
Organization Name:SPOGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RANKINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-471-4556
Mailing Address - Street 1:1717 N AKARD ST # 220
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2301
Mailing Address - Country:US
Mailing Address - Phone:214-471-4556
Mailing Address - Fax:
Practice Address - Street 1:1400 W NORTHWEST HWY
Practice Address - Street 2:SUITE #240
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:214-471-4556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory