MEDICARE: MRS. SUSAN KALISTER HERDMAN PAC

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	363A00000X	Physician Assistant	PA01125	TX

General Provider Information

NPI Number	:	1356302731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN KALISTER HERDMAN PAC

Provider Business Mailing Address
First Line	:	11325 FALLBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4232
Country	:	US
Telephone Number	:	281-890-7773
Fax Number	:

Provider Business Practice Location Address
First Line	:	11325 FALLBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4232
Country	:	US
Telephone Number	:	281-890-7773
Fax Number	:

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	09/17/2024

Similar Medicare Providers

1679541478 — DR. PHILLIPS KAY CHAMPION MD
Practice Location Address:

11321 FALLBROOK DR
HOUSTON, TX
77065-4232

Practice Phone: 832-237-3500
Practice Fax:

1770543191 — ROBERT S. BELL MD, PA
Practice Location Address:

11325 FALLBROOK DR.
HOUSTON, TX
77065-4232

Practice Phone: 281-890-7773
Practice Fax: 281-890-7798

1366403735 — ROBERT STEVEN BELL MD
Practice Location Address:

11325 FALLBROOK DR
HOUSTON, TX
77065-4232

Practice Phone: 281-890-7773
Practice Fax:

1396798799 — DR. KIMBERLEA WARD STATON M.D.
Practice Location Address:

11325 FALLBROOK DR
HOUSTON, TX
77065-4232

Practice Phone: 281-890-7773
Practice Fax: 281-890-7798

1730128141 — CHRISTINE DIANE POSPISIL RD
Practice Location Address:

11321 FALLBROOK DR
HOUSTON, TX
77065-4232

Practice Phone: 832-237-3500
Practice Fax: 832-237-0200

1730116740 — DIABETES CENTERS OF AMERICA, INC
Practice Location Address:

11321 FALLBROOK DR
HOUSTON, TX
77065-4232

Practice Phone: 832-237-3500
Practice Fax: 832-237-0200

Directions to “ MRS. SUSAN KALISTER HERDMAN PAC” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.