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1275536179

NPI Code Detail

MEDICARE: DR. DENISE WEATHERS SUTLER M.D.

MEDICARE: DR. DENISE WEATHERS SUTLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	35076975S	OH
2	207V00000X	Obstetrics & Gynecology Physician	Q9912	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	160057637	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0704238	OTHER	OH	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	288088	OTHER	OH	AMERIGROUP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	76975	OTHER	OH	HUMANA
7	000000270800	OTHER	OH	ANTHEM
8	311575051042	OTHER	OH	CARESOURCE
9	3119396	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1275536179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE WEATHERS SUTLER M.D.

Provider Business Mailing Address
First Line	:	28602 HOFFMAN SPRING LN
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-1664
Country	:	US
Telephone Number	:	513-706-2555
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1906
Country	:	US
Telephone Number	:	713-790-1234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	11/11/2019

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Directions to “ DR. DENISE WEATHERS SUTLER M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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