MEDICARE: SUSAN K. PANZARELLA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332BX2000X	Oxygen Equipment & Supplies (DME)
3	335E00000X	Prosthetic/Orthotic Supplier
4	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	V16521	OTHER	TX	HOMELINK
4	531483	OTHER	TX	BCBS
5	531601	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1972771715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN K. PANZARELLA

Provider Business Mailing Address
First Line	:	9652 FM 1960 BYPASS RD W
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-4039
Country	:	US
Telephone Number	:	281-446-7771
Fax Number	:	281-446-7701

Provider Business Practice Location Address
First Line	:	9652 FM 1960 BYPASS RD W
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-4039
Country	:	US
Telephone Number	:	281-446-7771
Fax Number	:	281-446-7701

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SUSAN K PANZARELLA
Credential	:
Telephone Number	:	281-446-7771

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	06/16/2008

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Practice Location Address:

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HUMBLE, TX
77338-4039

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Directions to “SUSAN K. PANZARELLA ” Practice Location

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